Arthritis, tenosynovitis, fasciitis, and bursitis due to sea urchin spines. A series of 12 cases in Réunion Island.
Arthritis, tenosynovitis, and bursitis due to sea urchin spine injuries have unique pathological features and run a chronic course until the spines are removed. Of the 40 cases of sea urchin spine-related clinical symptoms published to date, only 12 had osteoarticular symptoms.


METHODS
We studied 12 cases with osteoarticular symptoms seen in Réunion Island from 1994 to 1998. There were nine cases of arthritis and one case each of tenosynovitis, fasciitis, and bursitis. The nine males and three females had an age range of 9 to 50 years.


RESULTS
The injury was at the knee in six cases, the foot in three, and the hand in three. The time from injury to lesion development ranged from two days to two and a half months. Laboratory tests were normal apart from evidence of mild inflammation in three of the arthritis cases. The spine was visible on plain radiographs in eight cases. Histology was done in seven patients and consistently showed a typical foreign body granuloma. Removal of the spine with synovectomy was performed in 11 cases and consistently ensured a full recovery.


CONCLUSIONS
The clinical manifestations and management in our patients were compared to those in earlier reports. The differential diagnosis of laboratory test, radiographic, and histologic findings is reviewed. Pathogenic hypotheses and the immunogenic effect of the protein sheath that surrounds sea urchin spines are discussed.


CONCLUSIONS
The diagnosis of these frequently under-recognized lesions rests on a careful history and on converging histologic, radiologic, and clinical findings.
Guyot-Drouot
M H
MH
Rheumatology Department, Roger Salengro Hospital, Lille, France.
Rouneau
D
D
Rolland
J M
JM
Solau-Gervais
E
E
Cotten
A
A
Flipo
R M
RM
Duquesnoy
B
B
D000293:Adolescent; D000328:Adult; D000818:Animals; D001168:Arthritis / Q000209:etiology*; D001733:Bites and Stings / Q000150:complications*; D002062:Bursitis / Q000209:etiology*; D002648:Child; D005208:Fasciitis / Q000209:etiology*; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D012617:Sea Urchins; D013717:Tenosynovitis / Q000209:etiology*