title: "Is this case of a very rare disease work-related?" A review of reported cases of Pacinian neuroma.
abstract: OBJECTIVE
  In response to a request for a medicolegal opinion from an orthopaedic technician with pacinian neuroma of the hand, we conducted a systematic review of reported cases designed to assess whether this rare disease could be considered to be work-related.
  
  
  METHODS
  We used Medline, Embase, Google Scholar, Google, and a manual search to identify reports of histologically confirmed pacinian neuroma of the hand manifesting after 15 years of age. Cases with available information (from article/authors) on personal history were considered eligible. We tabulated information on age/gender; localization and histopathologic features; signs/symptoms; history of local trauma; occupation, sports/hobbies or other physical exposures; right- or left-handedness; and outcome.
  
  
  RESULTS
  We found 44 eligible cases (including the present referral). Of these, 21 (48%) followed a trauma [<6 months from onset/presentation (N=7); 0.5-2 years from onset (N=6); ≥ 2 years from onset (N=7); and timing unknown (N=1)] involving the same anatomic site. Three of these 21 traumas definitely occurred at work, and a further 2 cases occurred at the site of definite work-related repetitive microtrauma.
  
  
  CONCLUSIONS
  The results reinforce the concept that pacinian neuroma of the hand can follow local trauma or repetitive microtrauma. Implicated traumas were either recent or remote, and they sometimes occurred while performing manual tasks at work. We concluded that the referred case could plausibly be considered work-related.
authors.affiliation: Università di Bologna, Unita Operativa di Medicina del Lavoro, Policlinico S.Orsola-Malpighi, via Pelagio Palagi, 9, I-40138 Bologna, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Zanardi
authors.forename: Robin Mt
authors.initials: RM
authors.lastname: Cooke
authors.forename: Antonino
authors.initials: A
authors.lastname: Maiorana
authors.forename: Stefania
authors.initials: S
authors.lastname: Curti
authors.forename: Andrea
authors.initials: A
authors.lastname: Farioli
authors.forename: Roberta
authors.initials: R
authors.lastname: Bonfiglioli
authors.forename: Francesco Saverio
authors.initials: FS
authors.lastname: Violante
authors.forename: Stefano
authors.initials: S
authors.lastname: Mattioli
mesh_terms: D000328:Adult; D012090:Cumulative Trauma Disorders / Q000150:complications; D006225:Hand / Q000473:pathology*; D006801:Humans; D008297:Male; D009463:Neuroma / Q000209:etiology* / Q000473:pathology; D009784:Occupational Diseases / Q000209:etiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D010141:Pacinian Corpuscles / Q000473:pathology*