Spontaneous tendon rupture in a patient with systemic sclerosis: a case report

BMC Musculoskelet Disord. 2022 Nov 22;23(1):1001. doi: 10.1186/s12891-022-05967-6.

Abstract

Background: Systemic sclerosis (SSc) is an incurable autoimmune disease characterized by progressive skin fibrosis and organ failure. Tenosynovitis is a common musculoskeletal manifestation, but tendon rupture has seldom reported in SSc.

Case presentation: We present a rare case of a 49-year-old female with SSc who has suffered from bilateral tendon rupture of the fourth and fifth digits with positive antinuclear antibody (ANA) and anti-centromere B antibody, but negative rheumatoid factor in serum. In the extensor tendons of the patient's hands, inflammation, edema, hypertrophy and tendon interruption were detected with ultrasound and magnetic resonance imaging(MRI). Tendon transfer repair surgery was performed and 10 mg/week methotrexate was then used in this patient. Her hand function was improved well with methotrexate and rehabilitation treatment postoperatively.

Conclusions: Early detection of tenosynovitis is necessary to prevent tendon rupture in SSc patients. Ultrasound and Magnetic Resonance Imaging appear to be useful examinations for evaluating tendon pathology for early detection.

Keywords: Case report; Rheumatic disease; Rupture; Systemic sclerosis(SSc); Tendon.

Publication types

  • Case Reports

MeSH terms

  • Female
  • Humans
  • Methotrexate
  • Middle Aged
  • Rupture, Spontaneous
  • Scleroderma, Systemic* / complications
  • Scleroderma, Systemic* / diagnostic imaging
  • Tendon Injuries* / complications
  • Tendon Injuries* / diagnostic imaging
  • Tendons / pathology
  • Tenosynovitis* / diagnostic imaging
  • Tenosynovitis* / etiology
  • Tenosynovitis* / surgery

Substances

  • Methotrexate