Diagnosis of plant-thorn synovitis by high-resolution ultrasonography: a case report and literature review.
Plant-thorn synovitis is an uncommon cause of arthritis and has not been reported in Asian countries. Zanthoxylum ailanthoides, an aromatic plant distributed in East Asia, is used as a spice in Taiwan. We reported a case of acute monoarthritis over the third metacarpo-phalangeal joint of the right hand after an injury by the thorn of the Zanthoxylum ailanthoides. A thorn foreign body of 2.7 mm in length was detected in the joint by high-resolution ultrasonography and led to a surgical synovectomy. The patient recovered completely after synovectomy. Plant-thorn synovitis is easily negligible. Early diagnosis is difficult and frequently delayed. The removal of thorn by synovectomy is the only curative treatment for plant-thorn synovitis. Compared to CT and MRI, ultrasonography is inexpensive, nonradioactive, repeatable, and easily accessible. It could detect foreign bodies that are smaller than 0.5 mm. High-resolution ultrasonography is a useful tool for detecting plant thorn and could promote early diagnosis.
Tung
Chien-Hsueh
CH
Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, N.160, Chung-Kang Road, Sec. 3, Taichung, 407, Taiwan.
Chen
Yi-Hsing
YH
Lan
Howard H C
HH
Hsieh
Tsu-Yi
TY
Chen
Der-Yuan
DY
Lan
Joung-Liang
JL
D005260:Female; D005549:Foreign-Body Reaction / Q000000981:diagnostic imaging*; D006801:Humans; D008662:Metacarpophalangeal Joint / Q000000981:diagnostic imaging*; D008875:Middle Aged; D013585:Synovitis / Q000000981:diagnostic imaging* / Q000209:etiology; D014463:Ultrasonography; D032106:Zanthoxylum