Tendonitis and Tenosynovitis

Introduction to tendonitis and tenosynovitis Tendon inflammation (tendonitis) and tendon sheath intimal inflammation (tenosynovitis) usually occur simultaneously, and the tendon sheath lined with synovial membrane is generally the most inflamed part, but the inflammatory reaction can be accompanied by the tendon wrapped (such as the deposition of calcium) . basic knowledge Sickness ratio: 0.05% Susceptible people: middle-aged and elderly Mode of infection: non-infectious Complications: suppurative tenosynovitis

Causes of tendonitis and tenosynovitis

Most of the causes of this disease are unknown. Most patients are middle-aged and elderly. Due to poor blood supply to the tendon and repeated minor trauma, it often causes large damage, repeated or severe trauma (incomplete fracture), strain, overwork (due to incompatibility). Exercise, etc., are the most common cause of illness, certain systemic diseases (common in rheumatoid arthritis, progressive systemic sclerosis, gout, Reiter's syndrome, and amyloidosis) and elevated blood cholesterol ( Type II hyperlipidemia can also affect the tendon sheath. In younger adults, especially women, disseminated gonococcal infection can cause mital tenosynovitis with or without localized synovitis.

Tendinitis and tenosynovitis prevention

Because the cause of this disease is unknown, there is no effective preventive measure, mainly to avoid some factors that may cause the disease. For patients who already have this disease, the main reason is to actively care, when the inflammation occurs, use ice treatment When the inflammation is not serious, use hot compress, and tie with the sports patch to assist the tendon activity. After acute urgency, moderate massage and activities should be performed to prevent the tendon and surrounding tissues from hardening.

Tendinitis and tenosynovitis complications Complications suppurative tenosynovitis

The most common disease is the chronic aseptic inflammation caused by the long-term mechanical friction of the tendon sheath in the tendon sheath. The pathological changes are mainly the inflammatory cells in the periorbital tissue. The fiber is degenerated and the tendon sheath is narrow.

Tendonitis and tenacinitis symptoms Common symptoms Thumb unexplained pain Postpartum finger pain Tendon sheath Dry muscle tendon Adhesive tendonitis Inflammation Wrist joint cystic protrusion Sacral styloid process Thoracic sternocleidomastoid adhesion Attachment tender pain

When you move or touch an inflamed tendon, it can cause pain. If you move the joint adjacent to the tendon, even if it is a slight activity, the patient will feel severe pain. The tendon sheath can be swollen due to inflammation and accumulation of fluid. Sometimes the tendon sheath is dry. When the tendon is relatively rubbed, it can produce a rubbing sensation. Rubbing sound can be heard with a stethoscope. There are many kinds of clinical tendonitis. Several common tendonitis are introduced:

(1) The most common diseases include shoulder joint capsule and related tendons, ulnar wrist flexor, total flexor, hip capsule and related tendons, hamstring tendon and Achilles tendon, and long abductor and thumb. Extensor muscles, which together use a fibrous sheath (deQuervain disease), the affected tendon is generally painful during activity, due to exudate accumulation and inflammation, the affected tendon sheath may have significant swelling; or although there is no exudate, when the tendon is active in the tendon sheath There is a sense of friction or a stethoscope can hear the rubbing sound, and there are different degrees of tenderness along the tendon. This tenderness can be quite intense, causing the affected part to lose mobility due to pain. X-ray examination shows that the tendon and its tendon sheath have calcium deposits.

(2) Pressing with your thumb, near the muscle groove or a little further away (when rotating the biceps tendon) can be tender, and resisting flexion and supination can aggravate local pain.

(3) Quervae disease is tenosygic or flexor hallucis tenosynovitis. There is local tenderness along the tendon without swelling. It is usually diagnosed. The patient is required to receive the thumb from the heart, and then make a fist to force the wrist to pull. Tendons and tendon sheaths can cause severe pain in the styloid process of the humerus, that is, the fist test is positive (Finkelstein test positive).

(4) femoral greater trochanter bursitis occurs in the lateral trochanter of the femoral trochanter, usually associated with chronic compression shock trauma or inflammation of the site (such as RA belt friction), characterized by femoral greater trochanter The surface of the carina is partially tender and has no swelling.

Examination of tendonitis and tenosynovitis

The diagnosis of this disease mainly depends on its clinical manifestations and physical examination, often using the tendon palpation:

Palpation of tendon: palpation of the wrist muscles are mainly the radial flexor digitorum, palmar long muscle, ulnar wrist flexor; the wrist muscles are mainly the temporal wrist length, short extensor muscle and ulnar wrist extensor; palpation Finger muscles, in turn, refer to the total extensor tendon, the intrinsic extensor tendon of the index finger, the intrinsic extensor tendon of the little finger, and then palpate the long abductor muscle, the extensor muscle of the thumb, and the extensor muscle of the thumb. Pay attention to whether the muscle tension changes or not. The sport is accessible.

The use of auxiliary examination is less, but X-ray examination shows that the tendon and its tendon sheath have calcium deposits. It also contributes to the diagnosis of this disease.

Diagnosis and diagnosis of tendonitis and tenosynovitis

diagnosis

Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.

Differential diagnosis

The disease needs to be differentiated from the ganglion cyst:

The ganglion cyst is more common in the clinic. It is more common in the foot. It is more common in young adults. The cyst is generally slow to develop. In addition to the local mass, there are few symptoms, occasionally local soreness. Individual cysts occur in the carpal tunnel or fistula, which can cause nerve compression. The corresponding symptoms.

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