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The muscles of the forearm that move the wrist, hand, and digits are numerous and diverse. They can be classified into two groups based on their location and function — the anterior and posterior compartment muscles.
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Directly acting muscle relaxants like dantrolene and botulinum toxin (BoNT) have distinct mechanisms and applications. Dantrolene, a hydantoin derivative, acts on the ryanodine receptor (RYR1) in skeletal muscle cells. RYR1 are calcium channels present at the sarcoplasmic reticulum membrane. In response to excitation, they release calcium ions from the sarcoplasmic reticulum to the cytosol. Calcium promotes actin-myosin-mediated contraction of muscles.
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The ankle is formed by the talocrural joint (crural = leg). It consists of the articulations between the talus bone of the foot and the distal ends of the tibia and fibula of the leg. The superior aspect of the talus bone is square-shaped and has three areas of articulation. The top of the talus articulates with the inferior tibia. This is the portion of the ankle joint that carries the body weight between the leg and foot. The sides of the talus are firmly held in position by the articulations...
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Wrist Extensor Tenosynovitis After COVID-19 Vaccination.

Andrew Jeong1, Thomas John Carroll1, Ronald Gonzalez1

  • 1Department of Orthopaedic Surgery, University of Rochester, Rochester, NY.

Journal of Hand Surgery Global Online
|December 18, 2023
PubMed
Summary
This summary is machine-generated.

A woman developed painful nodules and tenosynovitis after a COVID-19 vaccine booster. Surgical intervention was required for persistent symptoms and recurrence, highlighting potential vaccine-related inflammatory responses.

Keywords:
COVID-19ExtensorTenosynovitisVaccinationWrist

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Area of Science:

  • Immunology
  • Rheumatology
  • Vaccinology

Background:

  • The mRNA-1273 vaccine (Moderna) is a widely used COVID-19 vaccine.
  • Adverse events following vaccination are typically mild and transient.
  • Rare inflammatory conditions can occur post-vaccination.

Observation:

  • A 54-year-old woman developed painful nodules on her left upper extremity and torso immediately after receiving the mRNA-1273 vaccine booster.
  • Nodules resolved spontaneously within days, except for those on the left wrist.
  • Persistent nodules on the left wrist showed findings consistent with extensor compartment tenosynovitis.

Findings:

  • Physical examination and imaging confirmed tenosynovitis in the second and fourth extensor compartments of the left wrist.
  • Surgical excision of the tenosynovitis was performed.
  • Symptoms recurred post-excision, necessitating a second surgical intervention.

Implications:

  • This case suggests a potential association between the mRNA-1273 vaccine and the development of tenosynovitis.
  • Recurrence of tenosynovitis after initial surgical management indicates a persistent inflammatory process.
  • Further investigation is warranted to understand the immunopathogenesis of vaccine-induced tenosynovitis.