Rubber Band Syndrome - An Invisible Syndrome

Abstract

Rubber band Syndrome or Dhaga syndrome is a clinical entity still prevalent in developing countries with strong religious practices which involves the use of elastic bands or threads tied commonly around the arms or legs especially in children as part of religious previews. Here we wanted to diagnose and describe the imaging findings in a case of Rubber Band Syndrome. A three-year-old female patient presented to the surgical out-patient department with complaints of pain, swelling and discoloration of the left wrist. Her mother gave a history of religious thread being tied to the left wrist of the patient two years back. The patient was referred to the Department of Radio-diagnosis for Imaging. Plain radiograph of the left wrist with forearm (AP and Lateral views) revealed a smooth bony defect over the outer aspect of the distal radius and ulna. This syndrome is an invisible syndrome as the patients themselves would not remember tying a religious thread or rubber band over the arm or leg as it is worn for years together due to religious beliefs. Hence, it is important to have knowledge of the condition and the imaging features to make an accurate diagnosis.

Rubber Band Syndrome (A.K.A Dhaga Syndrome) is a rare disorder which is caused by elastic bracelets or rubber bands or ceremonial threads worn for decorative or religious reasons and constricting mainly the wrist. ^[1] All the cases were reported in children especially chubby children. ^[2]

The rubber band/ thread remains unnoticed on the child’s arm which slowly burrows through the skin progressing deeper and becomes invisible during physical examination. In severe cases, the constriction worsens and results in neurovascular deficits.

Timely diagnosis by imaging is required in such cases as the physical examination may not reveal any foreign body and prevent lifelong morbidity to the child.