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Computed tomography-guided bupivacaine and corticosteroid injection for the treatment of symptomatic calcification in the great toe tendon

Authors Karatoprak O, Karaca S, Erdem MN, Karaman O, Hamzaoglu A

Received 19 December 2013

Accepted for publication 15 January 2014

Published 29 April 2014 Volume 2014:7 Pages 23—25


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 4

Omer Karatoprak,1 Sinan Karaca,2 Mehmet Nuri Erdem,3 Ozgur Karaman,2 Azmi Hamzaoglu4

1Department of Orthopedic Surgery, Kadikoy Florence Nightingale Hospital, Istanbul, Turkey; 2Department of Orthopedic Surgery, Fatih Sultan Mehmet Training and Research Hospital Atasehir, Istanbul, Turkey; 3Department of Orthopedics and Traumatology, Kolan International Hospital Sisli, Istanbul, Turkey; 4Department of Orthopedic Surgery, Istanbul Florence Nightingale Hospital, Istanbul Turkey

Background: Calcification in the great toe tendon is a rare disorder that is characterized by the deposition of calcium on degenerative collagen fibrils.
Case presentations: In this report, we present two cases of calcific tendonitis: one in the adductor hallucis and the other in the flexor hallucis longus tendon. We preferred computed tomography-guided steroid injection in our cases because of pain unresponsive to conservative treatment. Patients were free of symptoms at the follow-up visit, 4 weeks after injection.
Conclusion: Calcification of the hallux tendons is a rare disorder. Treatment of tendonitis consists of nonsteroidal anti-inflammatory drugs. Local anesthetic and steroid injection may be considered in cases unresponsive to conservative treatment. Because of the anatomic location of tendons, injection could be difficult. Computed tomography guidance may improve the success rate of injections.

Keywords: bupivacaine, calcification, great toe tendons, corticosteroid injection

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