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

• Published in: BMC musculoskeletal disorders 2022-11, Vol.23 (1), p.1001-6, Article 1001
• Main Authors: Lin, Cong, Shen, Jun, Jiang, Zhixing, Cheng, Yi, Shen, Yundong, Ren, Guoqiang, Xu, Wendong, Wan, Weiguo, Cao, Ling, Zou, Hejian, Zhu, Xiaoxia
• Format: Article
• Language: English
• Subjects: Antibodies; Antinuclear antibodies; Arthritis; Autoimmune diseases; Care and treatment; Case Report; Case reports; Complications and side effects; Diagnosis; Dosage and administration; Edema; Female; Fibrosis; Friction; Hands; Humans; Hypertrophy; Inflammation; Magnetic resonance imaging; Methods; Methotrexate; Middle Aged; Musculoskeletal diseases; Osteoarthritis; Patients; Rehabilitation; Rheumatic disease; Rheumatoid factor; Risk factors; Rupture; Rupture, Spontaneous; Scleroderma; Scleroderma (Disease); Scleroderma, Systemic - complications; Scleroderma, Systemic - diagnostic imaging; Skin diseases; Surgery; Systemic scleroderma; Systemic sclerosis; Systemic sclerosis(SSc); Tendon; Tendon injuries; Tendon Injuries - complications; Tendon Injuries - diagnostic imaging; Tendons; Tendons - pathology; Tenosynovitis; Tenosynovitis - diagnostic imaging; Tenosynovitis - etiology; Tenosynovitis - surgery; Ultrasonic imaging; Ultrasound; Wrist
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/s12891-022-05967-6

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. 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. 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.