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Extensor digitorum longus tenosynovitis

Case contributed by Yaïr Glick
Diagnosis certain

Presentation

Penetrating injury to the anterior aspect of the ankle two weeks previously. Severe cellulitis around the wound. Referred for assessing joint involvement in the infectious process.

Patient Data

Age: 10 years
Gender: Male
ultrasound

Extensive inflammatory infiltration of the soft tissues demonstrated around the wound, showing hyperemia on Doppler interrogation.
The extensor tendons at the anterior aspect of the ankle appear normal, including tibialis anterior, extensor hallucis longus, and extensor digitorum longus; however, there is considerable thickening of the extensor digitorum longus tendon sheath, which is involved in the inflammatory process, showing pronounced hyperemia on Doppler interrogation as well.

The peroneal tendons at the lateral aspect of the ankle appear normal.
No fluid demonstrated in the anterior recess of the tibiotalar joint or in the talonavicular joint.

Case Discussion

A clear case of tenosynovitis of the extensor digitorum longus tendon sheath, which is involved in the inflammatory process in the soft tissues. The tendon itself appears unaffected.

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