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Idiopathic palmar fasciitis with polyarthritis syndrome.

Sung YK, Park MH, Yoo DH - J. Korean Med. Sci. (2006)

Bottom Line: The radiologic and histological examinations confirmed it with palmar fasciitis and polyarthritis syndrome (PFPAS).PFPAS is an uncommon disorder characterized by progressive flexion contractures of both hands, inflammatory fasciitiis, fibrosis, and a generalized inflammatory arthritis.We present here in a young Korean patient with idiopathic PFPAS who was successfully treated with administration of corticosteroid.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Division of Rheumatology and the Hospital for Rheumatic Diseases, Hanyang University Medical Center, Seongdong-Gu, Seoul, Korea.

ABSTRACT
A 31-yr-old Korean woman was presented with 4-month history of bilateral hand swelling and stiffness. On clinical examination, she had a painful synovitis of both hands, wrists, knees and ankles. The radiologic and histological examinations confirmed it with palmar fasciitis and polyarthritis syndrome (PFPAS). PFPAS is an uncommon disorder characterized by progressive flexion contractures of both hands, inflammatory fasciitiis, fibrosis, and a generalized inflammatory arthritis. Although most reported cases of PFPAS have been associated with various malignancies, our patient have not been associated with malignancy during 24 months follow up period from her first symptom onset. Her symptoms were improved with moderate dose of corticosteroid and she is currently taking prednisone 5 mg daily without any evidence for internal malignancy. We present here in a young Korean patient with idiopathic PFPAS who was successfully treated with administration of corticosteroid.

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Related in: MedlinePlus

Hands of the patient. It shows the digital flexion contractures and the thickened palmar fascia. The MCP, and PIP joints were tender, and swollen.
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Figure 1: Hands of the patient. It shows the digital flexion contractures and the thickened palmar fascia. The MCP, and PIP joints were tender, and swollen.

Mentions: On clinical examination, she had a painful synovitis of both hands, wrists, knees and ankles. Her hands were mildly edematous (Fig. 1). However, the overlying skin was normal, with no evidence of telangiectasia, digital pitting, or of systemic sclerosis elsewhere. She was unable to flex or extend her fingers. The hands were warm with an intact sensory examination and normal sweat pattern. The radiography of both hands showed soft tissue swellings on PIP joints without erosive changes and other joint radiographs were normal. Technetium-99m bone scan showed a slight increased uptake in both hands, wrists, shoulders, knees, ankles, and feet. A magnetic resonance image (MRI) of the forearm revealed diffuse enhancements in the fascia, extensor and flexor tendons and some muscles including the extensor digiti minimi muscle and flexor carpi ulnaris muscles (Fig. 2).


Idiopathic palmar fasciitis with polyarthritis syndrome.

Sung YK, Park MH, Yoo DH - J. Korean Med. Sci. (2006)

Hands of the patient. It shows the digital flexion contractures and the thickened palmar fascia. The MCP, and PIP joints were tender, and swollen.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2721944&req=5

Figure 1: Hands of the patient. It shows the digital flexion contractures and the thickened palmar fascia. The MCP, and PIP joints were tender, and swollen.
Mentions: On clinical examination, she had a painful synovitis of both hands, wrists, knees and ankles. Her hands were mildly edematous (Fig. 1). However, the overlying skin was normal, with no evidence of telangiectasia, digital pitting, or of systemic sclerosis elsewhere. She was unable to flex or extend her fingers. The hands were warm with an intact sensory examination and normal sweat pattern. The radiography of both hands showed soft tissue swellings on PIP joints without erosive changes and other joint radiographs were normal. Technetium-99m bone scan showed a slight increased uptake in both hands, wrists, shoulders, knees, ankles, and feet. A magnetic resonance image (MRI) of the forearm revealed diffuse enhancements in the fascia, extensor and flexor tendons and some muscles including the extensor digiti minimi muscle and flexor carpi ulnaris muscles (Fig. 2).

Bottom Line: The radiologic and histological examinations confirmed it with palmar fasciitis and polyarthritis syndrome (PFPAS).PFPAS is an uncommon disorder characterized by progressive flexion contractures of both hands, inflammatory fasciitiis, fibrosis, and a generalized inflammatory arthritis.We present here in a young Korean patient with idiopathic PFPAS who was successfully treated with administration of corticosteroid.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Division of Rheumatology and the Hospital for Rheumatic Diseases, Hanyang University Medical Center, Seongdong-Gu, Seoul, Korea.

ABSTRACT
A 31-yr-old Korean woman was presented with 4-month history of bilateral hand swelling and stiffness. On clinical examination, she had a painful synovitis of both hands, wrists, knees and ankles. The radiologic and histological examinations confirmed it with palmar fasciitis and polyarthritis syndrome (PFPAS). PFPAS is an uncommon disorder characterized by progressive flexion contractures of both hands, inflammatory fasciitiis, fibrosis, and a generalized inflammatory arthritis. Although most reported cases of PFPAS have been associated with various malignancies, our patient have not been associated with malignancy during 24 months follow up period from her first symptom onset. Her symptoms were improved with moderate dose of corticosteroid and she is currently taking prednisone 5 mg daily without any evidence for internal malignancy. We present here in a young Korean patient with idiopathic PFPAS who was successfully treated with administration of corticosteroid.

Show MeSH
Related in: MedlinePlus