{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T07:51:11Z","timestamp":1777881071860,"version":"3.51.4"},"reference-count":27,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010740","name":"Asahi Kasei Pharma Corporation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010740","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Orthop Surg (Hong Kong)"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:p>Purpose<\/jats:p>\n                  <jats:p>We aimed to evaluate the extent of collagenase clostridium histolyticum (CCH) diffusion in Dupuytren\u2019s contracture (DC) for tissues outside of the contracture cord using Magnetic Resonance Imaging (MRI) immediately after CCH injection. Methods: 10 male patients aged 57\u201379 with DC of the metacarpophalangeal (MCP) joints were examined. Extension deficits were 10\u201360\u00b0(mean, 34.3) and 0\u201360\u00b0(mean, 26.6) in the MCP and proximal interphalangeal (PIP) joints, respectively. CCH injection was performed according to the standard method. MRI was performed within 15\u00a0min of CCH injection. Results: In all 10 cases, the extended area of high-intensity signal change outside of the cord was observed on short-T1 inversion recovery images (STIRs). Continuity from the insertion site was observed in the area of signal change involving the flexor tendon and neurovascular bundle. The signal change area spanned distally and proximally beyond the injection level. The signal change area expanded along the tendon sheath but no signal changes were observed inside the flexor tendon, suggesting the tendon sheath serves as a protective barrier from the CCH solution. After 1\u00a0week of injection, the mean decrease in contracture was 32.5\u00b0(94.7%) for the MCP joint and 19.8\u00b0(74.4%) for the PIP joint. In nine out of 10 cases, the extension deficit was within five degrees of full extension in the affected finger. There was no neurovascular injury or tendon rupture at 3\u00a0months of observation. Conclusions: MRI indicated the possible leakage of the drug outside of the cord during the early phase after administration, suggesting that CCH could persistently affect healthy tissues until CCH inactivates its enzyme process.<\/jats:p>","DOI":"10.1177\/23094990211047281","type":"journal-article","created":{"date-parts":[[2021,10,16]],"date-time":"2021-10-16T01:27:42Z","timestamp":1634347662000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Magnetic resonance imaging of diffusion characteristics following collagenase clostridium histolyticum injection in Dupuytren\u2019s contracture"],"prefix":"10.1177","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5036-5118","authenticated-orcid":false,"given":"Hiroko","family":"Iwakawa","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shigeharu","family":"Uchiyama","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Okaya City Hospital, Okayama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasunari","family":"Fujinaga","sequence":"additional","affiliation":[{"name":"Department of Radiology, Shinshu University School of Medicine, Matsumoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masanori","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masatoshi","family":"Komatsu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyuki","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,10,15]]},"reference":[{"key":"bibr1-23094990211047281","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1936.01180200142007"},{"key":"bibr2-23094990211047281","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2012.10.008"},{"issue":"4","key":"bibr3-23094990211047281","doi-asserted-by":"crossref","first-page":"e004166","DOI":"10.1136\/bmjopen-2013-004166","volume":"4","author":"Atroshi 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