Chondrolysis and joint destruction secondary to snake envenomation

Although snakebite injuries to the hand are common, intra-articular envenomation has rarely been reported. In this article, we describe a patient who was bitten by a rattlesnake and whose left-index-finger distal interphalangeal joint sustained intra-articular envenomation that resulted in aseptic chondrolysis and severe joint destruction 1.5 years later. Multiple cultures and biopsies were negative, and histology was consistent with nonspecific degenerative changes secondary to necrosis of the articular cartilage from retained toxins. The patient chose arthrodesis; 24 months postoperatively, he was pain-free and had returned to work.