Images in Clinical Rheumatology
Infectious Tenosynovitis of the Foot Extensors
Tenosinovitis infecciosa del aparato extensor del pie
Carlos Guillén Astete
, Ana Rodríguez García, Marta Prieto Morales, Antonio Zea Mendoza
Corresponding author
Servicio de Reumatología, Hospital Universitario Ramón y Cajal, Madrid, Spain
Read
18224
Timeswas read the article
2600
Total PDF
15624
Total HTML
Share statistics
array:24 [ "pii" => "S2173574313000725" "issn" => "21735743" "doi" => "10.1016/j.reumae.2013.01.011" "estado" => "S300" "fechaPublicacion" => "2014-01-01" "aid" => "541" "copyright" => "Elsevier España, S.L.. All rights reserved" "copyrightAnyo" => "2012" "documento" => "article" "crossmark" => 0 "subdocumento" => "sco" "cita" => "Reumatol Clin. 2014;10:56-7" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 5077 "formatos" => array:3 [ "EPUB" => 51 "HTML" => 4649 "PDF" => 377 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S1699258X13000521" "issn" => "1699258X" "doi" => "10.1016/j.reuma.2013.01.004" "estado" => "S300" "fechaPublicacion" => "2014-01-01" "aid" => "541" "copyright" => "Elsevier España, S.L." "documento" => "article" "crossmark" => 0 "subdocumento" => "sco" "cita" => "Reumatol Clin. 2014;10:56-7" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 10014 "formatos" => array:3 [ "EPUB" => 166 "HTML" => 7981 "PDF" => 1867 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Reumatología clínica en imágenes</span>" "titulo" => "Tenosinovitis infecciosa del aparato extensor del pie" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "56" "paginaFinal" => "57" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Infectious tenosynovitis of the foot extensors" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 882 "Ancho" => 900 "Tamanyo" => 122900 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Ecografía de la región dorsal del pie izquierdo. A: corte longitudinal del extensor del tercer dedo. B: corte transversal del mismo tendón. Flecha hueca: límites de la vaina del tendón. Cabeza de flecha: límites del tendón dentro de la vaina.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Carlos Guillén Astete, Ana Rodríguez García, Marta Prieto Morales, Antonio Zea Mendoza" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Carlos" "apellidos" => "Guillén Astete" ] 1 => array:2 [ "nombre" => "Ana" "apellidos" => "Rodríguez García" ] 2 => array:2 [ "nombre" => "Marta" "apellidos" => "Prieto Morales" ] 3 => array:2 [ "nombre" => "Antonio" "apellidos" => "Zea Mendoza" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173574313000725" "doi" => "10.1016/j.reumae.2013.01.011" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574313000725?idApp=UINPBA00004M" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X13000521?idApp=UINPBA00004M" "url" => "/1699258X/0000001000000001/v2_201402140038/S1699258X13000521/v2_201402140038/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2173574313000749" "issn" => "21735743" "doi" => "10.1016/j.reumae.2013.01.013" "estado" => "S300" "fechaPublicacion" => "2014-01-01" "aid" => "549" "copyright" => "Elsevier España, S.L." "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Reumatol Clin. 2014;10:58-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 3310 "formatos" => array:3 [ "EPUB" => 55 "HTML" => 2887 "PDF" => 368 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Transient Osteoporosis of Both Hips in Pregnancy" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "58" "paginaFinal" => "59" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Osteoporosis transitoria de ambas caderas en el embarazo" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 951 "Ancho" => 990 "Tamanyo" => 94923 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Restoration of Normality on MRI.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Carlos Bruscas Izu, Sara San Juan de la Parra" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Carlos" "apellidos" => "Bruscas Izu" ] 1 => array:2 [ "nombre" => "Sara" "apellidos" => "San Juan de la Parra" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1699258X13000600" "doi" => "10.1016/j.reuma.2013.01.009" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X13000600?idApp=UINPBA00004M" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574313000749?idApp=UINPBA00004M" "url" => "/21735743/0000001000000001/v2_201402090008/S2173574313000749/v2_201402090008/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173574314000033" "issn" => "21735743" "doi" => "10.1016/j.reumae.2013.04.007" "estado" => "S300" "fechaPublicacion" => "2014-01-01" "aid" => "570" "copyright" => "Elsevier España, S.L." "documento" => "article" "crossmark" => 0 "subdocumento" => "sco" "cita" => "Reumatol Clin. 2014;10:54-5" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1544 "formatos" => array:3 [ "EPUB" => 49 "HTML" => 1152 "PDF" => 343 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Images in clinical rheumatology</span>" "titulo" => "Lumbar myositis associated with <span class="elsevierStyleItalic">Toxocara</span> spp. infection" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "54" "paginaFinal" => "55" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Miositis lumbar asociada a infección por <span class="elsevierStyleItalic">Toxocara</span> spp" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 843 "Ancho" => 2501 "Tamanyo" => 145077 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Axial and coronal planes of the patient's MRI, both showing T2-Fat saturation high signals in intramuscular structures. (A) Axial plane. (B) Coronal plane.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Anne-Pauline Bellanger, Michel Runge, Daniel Wendling, Philippe Humbert" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Anne-Pauline" "apellidos" => "Bellanger" ] 1 => array:2 [ "nombre" => "Michel" "apellidos" => "Runge" ] 2 => array:2 [ "nombre" => "Daniel" "apellidos" => "Wendling" ] 3 => array:2 [ "nombre" => "Philippe" "apellidos" => "Humbert" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1699258X13001022" "doi" => "10.1016/j.reuma.2013.04.008" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X13001022?idApp=UINPBA00004M" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574314000033?idApp=UINPBA00004M" "url" => "/21735743/0000001000000001/v2_201402090008/S2173574314000033/v2_201402090008/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Images in Clinical Rheumatology</span>" "titulo" => "Infectious Tenosynovitis of the Foot Extensors" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "56" "paginaFinal" => "57" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Carlos Guillén Astete, Ana Rodríguez García, Marta Prieto Morales, Antonio Zea Mendoza" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Carlos" "apellidos" => "Guillén Astete" "email" => array:2 [ 0 => "caranguillen@gmail.com" 1 => "cguillen.hrc@salud.madrid.org" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Ana" "apellidos" => "Rodríguez García" ] 2 => array:2 [ "nombre" => "Marta" "apellidos" => "Prieto Morales" ] 3 => array:2 [ "nombre" => "Antonio" "apellidos" => "Zea Mendoza" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Reumatología, Hospital Universitario Ramón y Cajal, Madrid, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tenosinovitis infecciosa del aparato extensor del pie" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 875 "Ancho" => 879 "Tamanyo" => 136641 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">MRI of the foot in two cross sections: distal third in the upper image and middle third in the lower image. The effusion and hypertrophy of the sheath and the integrity of the cortical bone and lack of skin involvement can be observed.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 50-year-old male came to the emergency room with fever and pain in the left foot for the past 10<span class="elsevierStyleHsp" style=""></span>h. He had no history of trauma.</p><p id="par0010" class="elsevierStylePara elsevierViewall">On physical examination we found erythema, and warm, tender swelling of the distal forefoot with pain intensified by flexion of the third toe.</p><p id="par0015" class="elsevierStylePara elsevierViewall">An ultrasound of the foot determined the presence of an hypoechoic effusion into the sheath of the extensor of the third toe at the middle and distal thirds with moderate color Doppler signal and no increase in skin thickness (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Since usually branches of the digitorum extensor have no sheath beyond the middle third of the forefoot<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> we confirmed the diagnosis with an MRI (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). We started antibiotic treatment with vancomycin from the first contact, and debridement was performed on the second day, draining 12<span class="elsevierStyleHsp" style=""></span>cc of purulent-looking fluid from which we identified a strain of <span class="elsevierStyleItalic">Staphylococcus aureus</span>, which coincided with the results of blood cultures.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Infectious tenosynovitis of the foot occurs most often at the plantar flexors and is related to cutaneous perforation by foreign bodies,<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> a very rare presentation is on the foot extensor region. Mechanical tenosynovitis of the extensor tendons is usually associated with chronic exposure to repeated trauma<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> that occurs in the ultramarathoner foot syndrome due to mechanical contact between the tendon and proximal osteophitic prominence wedges.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Cellulitis of the dorsum of the foot is the first differential diagnosis. The diagnosis can be made through ultrasound<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> visualizing the tendon sheath immersed in a hypoechoic fluid and confirmed through aspiration and microbiological study. MRI can also assess the existence of<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6,7</span></a> bone involvement. Antibiotic treatment should be started before the diagnostic suspicion, although the duration and route of administration is heterogeneous in the few similar case reports found.<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8–10</span></a> In our opinion, systemic compromise justifies intravenous antibiotic treatment.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical Responsibilities</span><p id="par0025" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Protection of people and animals</span>. The authors state that no experiments were performed on humans or animals.<span class="elsevierStyleVsp" style="height:0.5px"></span><span class="elsevierStyleBold">Data confidentiality</span>. The authors declare that they have followed the protocols of their workplace regarding the publication of data from patients and all patients included in the study have received sufficient information and gave their written informed consent to participate in this study.<span class="elsevierStyleVsp" style="height:0.5px"></span><span class="elsevierStyleBold">Right to privacy and informed consent</span>. The authors have obtained informed consent from patients and/or subjects referred to in the article. This document is in the possession of the author of correspondence.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Disclosures</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors have no disclosures to make.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Ethical Responsibilities" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Disclosures" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please, cite this article as: Guillén Astete C, et al. Tenosinovitis infecciosa del aparato extensor del pie. Reumatol Clin. 2014;10:56–57.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 882 "Ancho" => 900 "Tamanyo" => 118617 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Ultrasound of the dorsal region of the left foot. (A) Longitudinal section of the third toe extensor. (B) Cross section of the same tendon. Hollow arrow: limits of the tendon sheath. Arrowhead: limits of the tendon within the sheath.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 875 "Ancho" => 879 "Tamanyo" => 136641 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">MRI of the foot in two cross sections: distal third in the upper image and middle third in the lower image. The effusion and hypertrophy of the sheath and the integrity of the cortical bone and lack of skin involvement can be observed.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical aspects of bursae and tendon sheaths of the foot" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "P. Hernandez" 1 => "W. Hernandez" 2 => "A. Hernandez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.7547/87507315-81-7-366" "Revista" => array:6 [ "tituloSerie" => "J Am Podiatr Med Assoc" "fecha" => "1991" "volumen" => "81" "paginaInicial" => "366" "paginaFinal" => "372" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1941580" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnosis of plant-thorn synovitis by high-resolution ultrasonography: a case report and literature review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C.-H. Tung" 1 => "Y.-H. Chen" 2 => "H.H.C. Lan" 3 => "T.-Y. Hsieh" 4 => "D.-Y. Chen" 5 => "J.-L. Lan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10067-006-0482-0" "Revista" => array:6 [ "tituloSerie" => "Clin Rheumatol" "fecha" => "2007" "volumen" => "26" "paginaInicial" => "849" "paginaFinal" => "851" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17273812" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Stenosing tenosynovitis and impingement of the peroneal tendons associated with hypertrophy of the peroneal tubercle" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "W.D. Bruce" 1 => "M.R. Christofersen" 2 => "D.L. Phillips" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Foot Ankle Int" "fecha" => "1999" "volumen" => "20" "paginaInicial" => "464" "paginaFinal" => "467" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10437932" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Extensor digitorum longus tenosynovitis caused by talar head impingement in an ultramarathon runner: a case report" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "H. Kobayashi" 1 => "M. Sakurai" 2 => "T. Kobayashi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Orthop Surg (Hong Kong)" "fecha" => "2007" "volumen" => "15" "paginaInicial" => "245" "paginaFinal" => "247" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sonography of tendons" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "O.S. Rasmussen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Scand J Med Sci Sports" "fecha" => "2000" "volumen" => "10" "paginaInicial" => "360" "paginaFinal" => "364" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11085564" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Radiographic imaging in osteomyelitis: the role of plain radiography, computed tomography, ultrasonography, magnetic resonance imaging, and scintigraphy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C. Pineda" 1 => "R. Espinosa" 2 => "A. Pena" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1055/s-0029-1214160" "Revista" => array:6 [ "tituloSerie" => "Semin Plast Surg" "fecha" => "2009" "volumen" => "23" "paginaInicial" => "80" "paginaFinal" => "89" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20567730" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Imaging of osteomyelitis: current concepts" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C. Pineda" 1 => "A. Vargas" 2 => "A.V. Rodríguez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.idc.2006.09.009" "Revista" => array:6 [ "tituloSerie" => "Infect Dis Clin North Am" "fecha" => "2006" "volumen" => "20" "paginaInicial" => "789" "paginaFinal" => "825" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17118291" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acute extensor hallucis longus tenosynovitis caused by gonococcal infection" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S. Faraj" 1 => "D. Stanley-Clarke" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "N Z Med J" "fecha" => "2003" "volumen" => "116" "paginaInicial" => "U421" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12740614" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acute gonococcal flexor tenosynovitis in an adolescent male with pharyngitis. A case report and literature review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R.A. Schaefer" 1 => "R.J. Enzenauer" 2 => "A. Pruitt" 3 => "R.S. Corpe" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Orthop Relat Res" "fecha" => "1992" "volumen" => "281" "paginaInicial" => "212" "paginaFinal" => "215" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1499214" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ankle extensor tendon synovitis due to a date palm thorn" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Nyska" 1 => "A.D. Sperber" 2 => "C.B. Howard" 3 => "A. Nyska" 4 => "S. Dekel" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Foot Ankle" "fecha" => "1989" "volumen" => "10" "paginaInicial" => "180" "paginaFinal" => "183" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2693286" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735743/0000001000000001/v2_201402090008/S2173574313000725/v2_201402090008/en/main.assets" "Apartado" => array:4 [ "identificador" => "5795" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in Clinical Rheumatology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735743/0000001000000001/v2_201402090008/S2173574313000725/v2_201402090008/en/main.pdf?idApp=UINPBA00004M&text.app=https://reumatologiaclinica.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574313000725?idApp=UINPBA00004M" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 22 | 15 | 37 |
| 2024 October | 197 | 41 | 238 |
| 2024 September | 203 | 41 | 244 |
| 2024 August | 267 | 53 | 320 |
| 2024 July | 283 | 45 | 328 |
| 2024 June | 223 | 44 | 267 |
| 2024 May | 287 | 52 | 339 |
| 2024 April | 163 | 23 | 186 |
| 2024 March | 169 | 38 | 207 |
| 2024 February | 198 | 30 | 228 |
| 2024 January | 164 | 28 | 192 |
| 2023 December | 184 | 33 | 217 |
| 2023 November | 155 | 27 | 182 |
| 2023 October | 180 | 50 | 230 |
| 2023 September | 250 | 39 | 289 |
| 2023 August | 205 | 29 | 234 |
| 2023 July | 216 | 31 | 247 |
| 2023 June | 252 | 30 | 282 |
| 2023 May | 195 | 33 | 228 |
| 2023 April | 168 | 17 | 185 |
| 2023 March | 204 | 34 | 238 |
| 2023 February | 187 | 31 | 218 |
| 2023 January | 151 | 31 | 182 |
| 2022 December | 173 | 37 | 210 |
| 2022 November | 213 | 35 | 248 |
| 2022 October | 219 | 53 | 272 |
| 2022 September | 196 | 51 | 247 |
| 2022 August | 192 | 53 | 245 |
| 2022 July | 185 | 55 | 240 |
| 2022 June | 157 | 53 | 210 |
| 2022 May | 212 | 54 | 266 |
| 2022 April | 232 | 59 | 291 |
| 2022 March | 186 | 65 | 251 |
| 2022 February | 199 | 34 | 233 |
| 2022 January | 235 | 65 | 300 |
| 2021 December | 195 | 56 | 251 |
| 2021 November | 232 | 46 | 278 |
| 2021 October | 223 | 62 | 285 |
| 2021 September | 208 | 40 | 248 |
| 2021 August | 198 | 39 | 237 |
| 2021 July | 345 | 53 | 398 |
| 2021 June | 192 | 36 | 228 |
| 2021 May | 207 | 51 | 258 |
| 2021 April | 586 | 109 | 695 |
| 2021 March | 284 | 47 | 331 |
| 2021 February | 181 | 37 | 218 |
| 2021 January | 177 | 32 | 209 |
| 2020 December | 140 | 29 | 169 |
| 2020 November | 147 | 29 | 176 |
| 2020 October | 121 | 23 | 144 |
| 2020 September | 147 | 33 | 180 |
| 2020 August | 137 | 19 | 156 |
| 2020 July | 85 | 20 | 105 |
| 2020 June | 100 | 22 | 122 |
| 2020 May | 80 | 9 | 89 |
| 2020 April | 49 | 15 | 64 |
| 2020 March | 19 | 7 | 26 |
| 2019 December | 1 | 1 | 2 |
| 2018 May | 18 | 2 | 20 |
| 2018 April | 154 | 12 | 166 |
| 2018 March | 201 | 10 | 211 |
| 2018 February | 108 | 3 | 111 |
| 2018 January | 109 | 5 | 114 |
| 2017 December | 98 | 5 | 103 |
| 2017 November | 108 | 7 | 115 |
| 2017 October | 123 | 6 | 129 |
| 2017 September | 106 | 3 | 109 |
| 2017 August | 142 | 10 | 152 |
| 2017 July | 117 | 10 | 127 |
| 2017 June | 144 | 4 | 148 |
| 2017 May | 119 | 18 | 137 |
| 2017 April | 118 | 9 | 127 |
| 2017 March | 148 | 5 | 153 |
| 2017 February | 92 | 4 | 96 |
| 2017 January | 112 | 9 | 121 |
| 2016 December | 164 | 12 | 176 |
| 2016 November | 179 | 8 | 187 |
| 2016 October | 233 | 8 | 241 |
| 2016 September | 318 | 15 | 333 |
| 2016 August | 255 | 6 | 261 |
| 2016 July | 106 | 4 | 110 |
| 2016 April | 1 | 0 | 1 |
| 2016 February | 1 | 0 | 1 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 1 | 0 | 1 |
| 2015 August | 2 | 0 | 2 |
| 2015 July | 73 | 10 | 83 |
| 2015 June | 109 | 11 | 120 |
| 2015 May | 112 | 23 | 135 |
| 2015 April | 71 | 11 | 82 |
| 2015 March | 83 | 9 | 92 |
| 2015 February | 113 | 6 | 119 |
| 2015 January | 104 | 6 | 110 |
| 2014 December | 75 | 7 | 82 |
| 2014 November | 79 | 6 | 85 |
| 2014 October | 57 | 10 | 67 |
| 2014 September | 45 | 8 | 53 |
| 2014 August | 52 | 8 | 60 |
| 2014 July | 43 | 13 | 56 |
| 2014 June | 87 | 10 | 97 |
| 2014 May | 76 | 19 | 95 |
| 2014 April | 63 | 8 | 71 |
| 2014 March | 75 | 18 | 93 |
| 2014 February | 52 | 18 | 70 |
Show all
