Retained blackthorn causing peroneal tendonitis: a case report.
We present the first reported case of peroneal tenosynovitis secondary to a retained blackthorn in a patient with a 4 months history of persistent pain and swelling around her lateral malleolus following a penetrating injury. Ultrasonography reported considerable subcutaneous fluid but no identifiable foreign body. Magnetic resonance imaging confirmed peroneal sheath synovitis with a possible retained foreign body posteriorly. Surgical exploration revealed marked synovitis and chronic inflammation of the peroneal sheath with the tip of a blackthorn deep to peroneus longus. This case illustrates the many ways in which penetrating blackthorn injuries may present. In particular it highlights the need for a high index of suspicion for retained foreign material and the need for further imaging and surgical exploration when symptoms do not resolve.
Wrexham Maelor Hospital, Orthopaedics, 141 Heol Isaf, Cardiff, United Kingdom. alunyewlett@doctors.org.uk
Alun
A
Yewlett
Jeremy
J
Oakley
Nilesh
N
Makwana
H J
HJ
Patel
D016512:Ankle Injuries / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D005549:Foreign-Body Reaction / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods; D018514:Plant Structures; D027861:Prunus; D052256:Tendinopathy / Q000175:diagnosis / Q000209:etiology*; D014950:Wounds, Penetrating / Q000150:complications* / Q000175:diagnosis / Q000601:surgery