Boutonnière deformity

Last revised by Leonardo Lustosa ◉ on 21 Jun 2022

Citation, DOI, disclosures and article data

Citation:

Niknejad M, Lustosa L, Chonde D, et al. Boutonnière deformity. Reference article, Radiopaedia.org (Accessed on 30 Sep 2023) 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, Mohammadtaghi Niknejad ◉

Disclosures:

At the time the article was created Mohammadtaghi Niknejad had no recorded disclosures.

View Mohammadtaghi Niknejad's current disclosures

Last revised:

21 Jun 2022, Leonardo Lustosa ◉

Disclosures:

At the time the article was last revised Leonardo Lustosa had no recorded disclosures.

View Leonardo Lustosa's current disclosures

Revisions:

22 times, by 13 contributors - see full revision history and disclosures

Systems:

Musculoskeletal

Sections:

Signs

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.