Finger stiffness or edema as presenting symptoms of eosinophilic fasciitis

Abstract

To investigate the clinical features and finger symptoms of eosinophilic fasciitis (EF), we reviewed five patients with EF. The chief complaint was pain, edema and/or stiffness of the extremities. The distal extremities were affected in all patients, and there was also proximal involvement in one patient. One patient had asymmetrical symptoms. All four patients with upper limb involvement had limited range of motion of the wrist joints, and three of them complained of finger symptoms. Two of these three patients showed slight non-pitting edema of the hands, and the other one had subcutaneous induration of the forearm. All four patients with lower limb symptoms had limited range of motion of the ankle joints, and two showed edema or induration of the legs. Inflammatory changes in the joints were not detected in any of the patients. Two patients displayed neither objective induration nor edema, and two patients had muscle tenderness. In conclusion, finger symptoms of patients with EF might be caused by fasciitis of the forearms, which leads to dysfunction of the long finger flexors and extensors as well as slight edema of hands. Limited range of motion of wrist and/or ankle joints indicates sensitively distal muscle dysfunction caused by fasciitis.

A case of eosinophilic fasciitis presenting with palmar stiffness

“…Eosinophilic fasciitis (EF) is a rare disease which is characterized by painful, progressive, symmetrical swelling, and induration of the skin. [ 1 ]…”

“…Although EF usually spares the fingers, there are some reports about involvement of the distal extremities. [ 1 ] Here is an unusual case of EF with palmar stiffness.…”

“…with hand involvement and decrease of range of joint movement along with palmar nonpitting edema, as was observed in our patient. [ 1 ] The author believed that these symptoms are related to forearm fasciitis, and the compression effect on the venous return caused finger edema and are not related to true sclerotic changes. [ 1 ]…”

Full-body physical therapy evaluation for pre- and post-hematopoietic cell transplant patients and the need for a modified rehabilitation musculoskeletal specific grading system for chronic graft-versus-host disease

“…Graft-versus-host disease (GVHD) can affect multiple organs including joints, skin, fascia, and ligaments [1], which can have a major impact on patient's quality of life in patients who underwent hematopoietic cell transplantation (HCT) [2]. From the current literature, it is well established that patients suffering from musculoskeletal (MSK) GVHD can present with a wide range of symptoms like fasciitis in the hands resulting in dysfunction of the long finger flexors and extensors along with edema of hands [3], avascular necrosis of the hips [4], and polymyositis causing proximal muscle weakness in the hips and the shoulders [5]. Unless these patients are assessed, and the MSK manifestations identified at an early stage, these patients remain at risk of developing contractures, muscle loss, loss of function eventually resulting in reduced range of motion (ROM), and delay in functional recovery.…”