Achilles paratendonitis as the initial manifestation of rheumatoid arthritis.
We report a case of rheumatoid arthritis in which the earliest symptom was bilateral paratendonitis of the Achilles tendons, followed by paratendonitis of a finger extensor. A series of musculoskeletal ultrasonograms revealed a progression from paratendonitis of the extensor tendon to erosive synovitis of the adjacent metacarpophalangeal joint. High-resolution ultrasonography combined with power Doppler imaging seems to be a useful and convenient tool both for diagnosing paratendonitis early and for closely monitoring the progressing inflammation.
Suzuki
Takeshi
T
Division of Rheumatology, Mitsui Memorial Hospital, 1 Kandaizumi-cho, Chiyoda-ku, Tokyo, 101-8643, Japan. suzuki-rheum@mitsuihosp.or.jp
Ishihara
Keiko
K
D000125:Achilles Tendon / Q000000981:diagnostic imaging / Q000473:pathology*; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D003937:Diagnosis, Differential; D018450:Disease Progression; D005260:Female; D006801:Humans; D008662:Metacarpophalangeal Joint / Q000000981:diagnostic imaging / Q000473:pathology; D008875:Middle Aged; D012460:Sulfasalazine / Q000627:therapeutic use; D013585:Synovitis / Q000150:complications / Q000473:pathology; D052256:Tendinopathy / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler / Q000379:methods
D018501:Antirheumatic Agents; D012460:Sulfasalazine