Arthroscopic Excision of Localized Nodular Tenosynovitis of Carpometacarpal Joint of Thumb: A Case Report and Review of Literature.

Giant cell tumors of tendon sheath are classified according to their clinical presentation as localized or diffuse, and they may occur at intra-articular or extra-articular locations. Although magnetic resonance imaging is mandatory and sufficient for diagnosis in many cases, histological examination is needed to confirm the diagnosis. Complete surgical resection is the mainstay of treatment. Radiotherapy as adjuvant or after recurrence shows promising results. Though small joint arthroscopy, especially of the thumb carpometacarpal (CMC) joint, is a relatively new technique and mainly used for the treatment of basal joint arthritis of the thumb, the indications are evolving. We report a rare case of nodular tenosynovitis of the CMC joint of the thumb managed with complete arthroscopic resection of the tumor, and no recurrence at a follow-up of 2.5 years. This is another addition to the list of indications for thumb CMC arthroscopy. Arthroscopic treatment provides the distinct advantage of thorough assessment of the articular cartilage, complete excision of the tumor via a minimally invasive technique, early return of function, and better cosmesis. To the best of our knowledge, this is the first such report of arthroscopic resection of nodular tenosynovitis of the thumb CMC joint.