Giant cell tumors of tendon sheath are classified according to their clinical presentation as localized or diffuse, and they may occur at intra-articular or extra-articular locations. Although magnetic resonance imaging is mandatory and sufficient for diagnosis in many cases, histological examination is needed to confirm the diagnosis. Complete surgical resection is the mainstay of treatment. Radiotherapy as adjuvant or after recurrence shows promising results. Though small joint arthroscopy, especially of the thumb carpometacarpal (CMC) joint, is a relatively new technique and mainly used for the treatment of basal joint arthritis of the thumb, the indications are evolving. We report a rare case of nodular tenosynovitis of the CMC joint of the thumb managed with complete arthroscopic resection of the tumor, and no recurrence at a follow-up of 2.5 years. This is another addition to the list of indications for thumb CMC arthroscopy. Arthroscopic treatment provides the distinct advantage of thorough assessment of the articular cartilage, complete excision of the tumor via a minimally invasive technique, early return of function, and better cosmesis. To the best of our knowledge, this is the first such report of arthroscopic resection of nodular tenosynovitis of the thumb CMC joint.

Lateral epicondylitis is the most common condition affecting the elbow and is self-limiting in most cases. However, when conservative treatment fails, surgery is required for resistant cases. In this study, we describe a novel technique for the management of chronic lateral epicondylitis. The advantage of our technique is that all the 3 major components of the disease (as also all types of failure described by Morrey) are simultaneously dealt with, that is, pathology of the tendon, posterior interosseous nerve compression and intra-articular pathology are all addressed. We prospectively reviewed 14 consecutive cases of resistant lateral epicondylitis operated with our technique at our Institute from 2008 to 2013 with a minimum 2 years follow up. We included patients between 18 and 65 years of age who in addition to lateral epicondylitis also had an intra-articular pathology along with symptoms/signs suggestive of posterior interosseous nerve compression and had undergone a conservative trial of atleast 12 months. Excluded were those cases with localized infection and severe ankylosis, whereas previous surgery on the same elbow was a relative contraindication. Postoperatively all patients showed improvement in the VAS score and grip strength. Twelve of the 14 patients (85.7%) in our series had good to excellent functional outcomes on the Mayo Elbow Performance Index. This technique can therefore be recommended for wider surgical use; however, prospective randomized studies with a longer follow-up would add further evidence about the effectiveness of our technique.