title: Diagnosis of plant-thorn synovitis by high-resolution ultrasonography: a case report and literature review.
abstract: 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.
authors.affiliation: Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, N.160, Chung-Kang Road, Sec. 3, Taichung, 407, Taiwan.
authors.forename: Chien-Hsueh
authors.initials: CH
authors.lastname: Tung
authors.forename: Yi-Hsing
authors.initials: YH
authors.lastname: Chen
authors.forename: Howard H C
authors.initials: HH
authors.lastname: Lan
authors.forename: Tsu-Yi
authors.initials: TY
authors.lastname: Hsieh
authors.forename: Der-Yuan
authors.initials: DY
authors.lastname: Chen
authors.forename: Joung-Liang
authors.initials: JL
authors.lastname: Lan
mesh_terms: 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