Finger retronychias detected early by 3D ultrasound examination

Abstract

Artículo de publicación ISIBackground A new pattern of ingrown nail, called retronychia is involved in the posterior translation of the whole nail unit producing paronychia. Objective To demonstrate an unusual case of paronychia that affected three of the fingers on the right hand. Methods We used 3D ultrasound to study the whole nail unit in the fingers of both the affected (right) and non affected (left) hand. Results Backward motion of the nail unit with decreased distance between the origin of the nail plates and the distal interphalangeal joint was clearly demonstrated by 3D ultrasound in the affected fingers. Conclusion 3D ultrasound provides non invasive and more understandable information about the physiopathological changes in retronychia

Sonography of the Nail

“…This abnormality can also appear as a total or partial posterior embedding of the nail unit. 3D ultrasound has been reported as being useful in the early detection and better clinical understanding of retronychia [ 10,11 ] (Figs. 18.6 and 18.7 ).…”

Ultrasonographic Criteria for Diagnosing Unilateral and Bilateral Retronychia

“…In addition, in nail psoriasis, there are other concomitant US signs, such as hypoechogenicity and increased thickness of the nail bed, loss of definition of the ventral plate, hyperechoic deposits in the ventral plate, loss of definition of both plates, and wavy and thickened plates. All of these signs differ greatly from the US findings for retronychia . However, a psoriatic nail can develop retronychia, particularly in late or severe stages; therefore, we must be aware to recognize these entities on US.…”

“…Retronychia is a nail disorder characterized by embedding of the proximal nail plate into the proximal nail fold, which clinically appears as an apparent halt to nail growth with a chronic proximal paronychia . It may be an underestimated condition that can appear after or concomitant to a severe illness, can be related to stress‐relevant situations, can be secondary to trauma, including sports injuries, or can appear as an idiopathic episode . Additionally, it has been reported that retronychia may have a similar etiology as Beau lines and onychomadesis.…”

“…Moreover, this condition is usually unresponsive to only antibiotics, and commonly, management is surgical (onysectomy: ie, proximal avulsion of the nail) . Retronychia can appear in association with onychomadesis (ie, fragmentation of the nail plate), and since its original description in 1999, there have been an increasing number of case reports …”

What′s new in nail disorders?

“…The new nail plate growth is often normal and the recurrences are not seen as in lateral ingrowth of nail plate. Wortsman et al [2] reported a case of triple finger retronychia resulting from trauma and the diagnosis was established using 3D ultrasonography (USG).…”