Nodular Tenosynovitis

Aka: Nodular Tenosynovitis, Tenosynovial Giant Cell Tumor

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II. Definitions

  1. Tenosynovial Giant Cell Tumor (Nodular Tenosynovitis)
    1. Lobulated benign tumor that encasing finger or toe tendons, and grows slowly over the course of years

III. Findings

  1. Swelling overlying the tendons of the finger (most common) or toes
  2. Second finger is most commonly affected

IV. Labs

  1. Histology
    1. Mononuclear cells
    2. Multinucleated Osteoclast-like giant cells
    3. Hemosiderin-laden Macrophages
    4. Foam cells
    5. Inflammatory infiltrate

V. Imaging

  1. XRay
    1. May demonstrate bony erosions
  2. Ultrasound
    1. Small growth that does not attach to tendon
  3. MRI
    1. T1 with low signal compared with Muscle
    2. T2 with hemosiderin deposition

VI. Management

  1. Surgical resection
    1. Recurrs in up to 15% of cases

VII. References

  1. Fotiadis (2011) Hand 6(3): 244-9 [PubMed]

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