Skip to main content
SpringerLink
Log in

Sea urchin spine arthritis in the foot

  • Case Report
  • Published:
Skeletal Radiology Aims and scope Submit manuscript

Abstract

We present a case of sea urchin spine arthritis (SUSA) in a 33-year-old woman who sustained penetrating trauma to the interphalangeal (IP) joint of the hallux while snorkeling in Japan. Serial radiographs and MRI were obtained over a period from 7 weeks to 10 months following injury. At 7 weeks radiographs revealed periarticular osteopenia and subtle marginal erosion, similar to the appearance of tuberculous arthritis. Over the ensuing months, radiographs and MRI documented progressive marginal and periarticular erosions with synovitis, despite preservation of cartilage space and restoration of bone mineral density. Delayed radiographs and imaging features mimic gouty arthropathy. Only the history points to the proper diagnosis, which was confirmed by histopathology, demonstrating necrobiotic granuloma with central fibrinoid necrosis following synovectomy and arthrodesis. The majority of previous case reports affected the hand, with few cases in the feet. In all, radiographic illustrations were limited and demonstrated only minimal osteolysis and periosteal reaction. No other report included MRI or serial radiographs over a long period to illustrate the natural progression of the disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

References

  1. McWilliam LJ, Curry A, Rowland PL, Watson JS. Spinous injury caused by a sea urchin. J Clin Pathol. 1991;44:428.

    Article  PubMed  CAS  Google Scholar 

  2. Dahl WJ, Jebson P, Louis DS. Sea urchin injuries to the hand: a case report and review of literature. Iowa Orthop J. 2010;30:153–6.

    PubMed  Google Scholar 

  3. Ahmad R, McCann PA, Barakat M, Astle L. Sea urchin spine injuries to the hand. J Hand Surg Eur. 2008;33:670.

    Article  CAS  Google Scholar 

  4. Liram N, Gomori M, Perouansky M. Sea urchin puncture resulting in PIP joint synovial arthritis: case report and MRI study. J Travel Med. 2000;7:43–5.

    Article  PubMed  CAS  Google Scholar 

  5. Guyot-Drouot MH, et al. Arthritis, tenosynovitis, fasciitis, and bursitis due to sea urchin spines. A series of 12 cases in Reunion Island. Joint Bone Spine. 2000;67:94–100.

    PubMed  CAS  Google Scholar 

  6. Morris L, Stevens A, Doherty M. Chronic Flexor Tenosynovitis: missed diagnosis for a decade. Ann Rheum Dis. 1996;55(9):597–9.

    Article  PubMed  CAS  Google Scholar 

  7. Wada T, Soma T, Gaman K, Usui M, Yamashita T. Sea urchin spine arthritis of the hand. J Hand Surg Am. 2008;33(3):398–401.

    Article  PubMed  Google Scholar 

  8. Newmeyer III WL. Management of sea urchin spines in the hand. J Hand Surg. 1988;13A:455–7.

    Google Scholar 

  9. De la Torre CC, Vega AA, Carracedo AA, Toribio JJ. Identification of Mycobacterium marinum in sea-urchin granulomas. Br J Dermatol. 2001;145:114–6.

    Article  PubMed  Google Scholar 

  10. Keren Y, Soderi M, Feldman A, Edelman M. Sea urchin wound—a patient case with chronic inflammation in the foot. Medicine. 2011;50:515–7.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Jacobi Medical Center, Bronx, New York, USA

    Javin Schefflein, Hilary Umans, David Ellenbogen & Maria Abadi

Authors
  1. Javin Schefflein
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hilary Umans
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. David Ellenbogen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Maria Abadi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hilary Umans.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Schefflein, J., Umans, H., Ellenbogen, D. et al. Sea urchin spine arthritis in the foot. Skeletal Radiol 41, 1327–1331 (2012). https://doi.org/10.1007/s00256-012-1409-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00256-012-1409-2

Keywords

Search

Navigation