ECU tendon frayed - what will this mean

[rheumatoidymummy]

Went to the hospital for an investigation of my right wrist under ultrasound yesterday. The plan was to do a steroid jab into the joint if inflammation was found but the radiologist wouldn't do it as he found that my ECU tendon, which I think controls bending of the wrist, was frayed and 'in distress' as he put it.

Has anyone else had this? Am worried that will mean my hand surgeon will want to do a darrach procedure to remove the eroded ulna head on the left side just like he did on the right side this time last year. I took weeks to recover from that and had a month of work. That was just because I had a rupture of the little finger extensor tendon - is the ECU more critical?

[earthwitch]

I don't know about your surgical options, but I do know that steroid injections into tendons aren't advised now, as they can lead to tendon rupture. Steroids are OK right into joints though. Your radiologist did the right thing.

[rheumatoidymummy in reply to earthwitch]

Thanks Earthwitch, good to know he did the right thing. That was the reason he gave for not doing it actually although he did say if the surgeon said it was ok to do it then he would ASAP. I was a bit distracted unfortunately as he was VERY good looking which helped take my mind off the discomfort he caused me when he did do a jab into a bursitis near my achilles tendon - apparently that was OK as the achilles is more resilient. ...

Will be interesting to see if anyone has any surgical experience in this area....

[Hidden]

That would be a welcome distraction I can see! Has the procedure on your right wrist helped you a lot in the long run? If so maybe worth it for the left wrist too despite the few weeks off with discomfort post op? My right wrist has given me a lot of bother lately too so I know how you feel. Not a lot we can do without our hands is there? Tilda x

[rheumatoidymummy in reply to Hidden]

Hi Tilda,

The right wrist is ok but I have lost a little function in my little finger and ring finger, they don't always do what I ask them to do.

I'll be guided by the surgeon but it would be helpful to know what I might expect. Forewarned is forearmed after all.

Xx

[Hidden]

Oh I see - well I have had no ops ever but I too have lost quite a lot of the function in my little finger on my right hand which had turned round and sticks right out always - and grip strength is quite poor now in this hand too. So this could possibly have occurred in your hand despite your wrist operation, as part of your RA perhaps? X

[rheumatoidymummy in reply to Hidden]

Maybe Tilda, I suppose it could well be....

I guess I'll never know! It seems I am quite prone to erosion though, I was only diagnosed four and a half years ago! Xx

[Hidden]

That's really unlucky for you Rheumatoidymummy

To be honestI don't really understand erosion. I had my hands x-rayed a few months ago looking for RA erosion specifically, and none was found I'm glad to say. But I'm surprised that there was no mention of any changes because my hands have definite signs of drifting, visible OA nodes and two permanently enlarged knuckles that people notice if they look at my hands - and I don't just mean inflammation but actually hard knuckle/bone that has formed since RA started along with the obvious OA. And I can't fully clench my hands or fully bend my wrists or weight bear using them. Not sure at what point this would show up in x-ray though. Tilda x

[Hidden]

Ps but I've only been diagnosed for 18 months.

[rheumatoidymummy]

Hmm. I guess we're all different. I have erosions in my wrists and some of my foot bones. I also have one big knuckle too, that was the first sign that something was wrong. It swelled up overnight when I was 7 weeks pregnant and has never gone down. It gets bigger every now and then if I'm not doing too well, funny eh?

The erosion shows up very clearly on x ray. It actually looks like something has been nibbling at the end of the bones at at the edges too.

Xx

[Hidden]

I think you are quite unusual and unlucky in this way probably but then perhaps when I'm another 3 years into RA it will show up clearly in my hands and wrists too? My GP said that he would be disappointed if my RA showed up in x-rays this soon when I'm in MTX. The middle knuckle is quite permanently large in my case and the forefinger one too. My wrists haven't been x-rayed but I don't think the erosion would show up in them either. Nothing else has been x rayed at all yet for me. Are you sero-negative I would be interested to know?

[rheumatoidymummy]

I'm sero-positive Tilda and had ccp present at my diagnosis tests.

My hand surgeon said he was concerned for my prognosis as I'd needed surgery so soon given the cocktail of DMARDs I've tried. I started MTX two months after I was diagnosed and then added in sulfasalazine and hydroxychloroquine. Now I'm injecting 22.5mg of MTX and taking hydroxychloroquine and leflunomide and STILL we don't have it under control. Silver lining to all this wrist trouble is that it strengthens my rheumatologist's argument to get me on anti-TNF as my DAS score isn't high enough to qualify for it at the moment.

My rheumatologist describes me as a 'problem case' and I'm guessing that's not a complement.