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Journal of Bone and Joint Surgery, 1969;51:1413-1419.
© 1969 by The Journal of Bone and Joint Surgery, Inc

Koch's Phenomenon Involving the Flexor Tendon Sheath

ADJUVANT-INDUCED TENOSYNOVITIS IN MAN

HARVEY B. CONKLIN 1, RAYMOND M. CURTIS M.D.2, and SHLOMO BEN-EFRAIM PH.D.3

1 Valley Forge General Hospital, Phoenixville, Pennsylvania 19460
2 2947 St. Paul Street, Baltimore, Maryland 21218
3 Israel Institute for Biological Research, Ness-Ziona, P. O. B. 19, Israel

A case of Koch's phenomenon due to the accidental injection of Freund's adjuvant in man is presented. The resulting tenosynovitis resembled rheumatoid synovitis. Possible relationships between the tubercle bacillus, adjuvant-induced arthritis, rheumatoid arthritis, and the eye lesion that developed in our patient are discussed, with emphasis on delayed hypersensitivity as the mediating mechanism.


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