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Giorgio Tamborrini1, Martin Schwab2, Tamara Hebert3

  • 1UZR - Ultraschallzentrum Rheumatologie und Universitätsspital Basel.

Praxis
|January 9, 2020
PubMed
Summary

Parvovirus B19 can cause chronic tenosynovitis, even when initial tests are negative. Early diagnosis and targeted treatment, like tenosynovectomy and steroid injection, can lead to full recovery.

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Area of Science:

  • Rheumatology
  • Infectious Diseases
  • Histopathology

Background:

  • Undifferentiated tenosynovitis presents diagnostic challenges.
  • Seronegative rheumatoid factor (RF) and anti-cyclic citrullinated peptide (ACPA) results can complicate diagnosis.
  • Chronic tenosynovitis requires thorough differential diagnosis.

Observation:

  • A case of chronic tenosynovitis in the 4th extensor tendon compartment is presented.
  • Initial presentation showed unremarkable history and normal laboratory results, leading to a diagnosis of seronegative tenosynovitis without arthritis.
  • Diagnostic and therapeutic tenosynovectomy was performed.

Findings:

  • Histologic examination revealed a positive polymerase chain reaction (PCR) for parvovirus B19.
  • Parvovirus B19 can manifest in the musculoskeletal system, often self-limiting.
Keywords:
ParvovirusTenosynovitisUltraschallVirusarthritistenosynovitisultrasoundviral arthritis

Related Experiment Videos

  • The patient had significant local findings requiring intervention.

    • Implications:

    • This case highlights parvovirus B19 as a potential cause of tenosynovitis.
    • Symptomatic treatment is generally recommended for parvovirus B19 musculoskeletal manifestations.
    • Complete tenosynovectomy followed by a single steroid injection resulted in complete recovery in this patient.