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Boutonnière deformity

Last revised by Leonardo Lustosa ◉ on 21 Jun 2022

Citation, DOI & article data

Citation:

Niknejad, M., Lustosa, L. Boutonnière deformity. Reference article, Radiopaedia.org. (accessed on 20 Aug 2022) https://doi.org/10.53347/rID-21573

DOI:

https://doi.org/10.53347/rID-21573

Permalink:

https://radiopaedia.org/articles/21573

rID:

21573

Article created:

31 Jan 2013 by Dr MT. Niknejad ◉

Revisions:

22 times by 13 users - see full revision history

System:

Musculoskeletal

Section:

Signs

Tags:

Synonyms:

Boutonniere deformities

Boutonnière deformity is the eponymous name of a musculoskeletal manifestation of rheumatoid arthritis presenting in a digit, with the combination of:

flexion contracture of a proximal interphalangeal (PIP) joint
extension of a distal interphalangeal (DIP) joint

Boutonnière deformities occur when the central slip of the extensor digitorum tendon is torn or stretched resulting in PIP joint flexion. Increasing PIP joint flexion causes further extensor retinaculum damage resulting in "buttonholing" of the proximal phalanx between the lateral bands of the extensor tendon. Secondary DIP joint extension then occurs ⁴.

Etiology

inflammatory arthritis ⁴
central slip of extensor digitorum tendinopathy or rupture ⁴

History and etymology

"Boutonnière" is French for buttonhole. With the loss of integrity of the central aspect of the extensor tendon at the PIP joint, the PIP joint flexes, passing between the lateral bands just as a button passes through the buttonhole of a shirt.