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Sunday, September 21, 2008

A Simple Guide to Tenosynovitis

A Simple Guide to Tenosynovitis
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What is Tenosynovitis?
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Tenosynovitis is the inflammation and swelling of the tendon sheaths (called the synovium) and the enclosed tendons.

It can occur together with tendinitis(inflammation of the tendons).

It can also cause stenosing tenosynovitis (tightening inflammation of the tendon sheaths).


What are the cause of Tenosynovitis?
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The cause of Tenosynovitis is unknown.

Some possible causes are:
1.Injury or trauma to the tendon

2.Repetitive usage of fingers and wrist joints

3.Arthritis of the joints may predispose to tenosynovitis

4.Systemic diseases such as multiple sclerosis ,amyloidosis, rheumatoid arthritis

5.Tenosynovitis occurs in families, and

6.It is generally seen more often in males than in females


What are the symptoms and signs of Tenosynovitis?
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Symptoms:
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1.Pain on movement of the tendon

2.Swelling of part of the tendon affected

3.Stenosis of the tendon sheath may be present

4.Stiffness of the tendon - inability to stretch

5.Pain is felt most beneath the bone of involved joints

Signs:

1.swelling over the involved tendon

2.Passive stretching of the tendon is painful.

3.There may be local tenderness of the inflamed tendon.

4.The tendons sheaths are usually swollen and thickened

5.The tendons may become stuck in the narrowed tendon sheaths (Trigger Finger)

6.There may be crepitations felt over the tendon as it moves across the sheaths


What is the complications of Tenosynovitis?
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Fibrosis and rupture of the inflamed tendon may occur leading to loss of function.


What is the Treatment of Tenosynovitis?
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Conservative treatment:
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1.rest of the tendon

2.Cold or ice may help reduce inflammation

3.Splints over the hand, wrist and elbow may help to rest the tendons

4.Pain killers such as NSAID(non-steroidal anti-inflammatory drugs) for pain

5.Muscle relaxant to relax muscles

6.injection of local anesthetic and long acting steroid into the affected sheath or tendon nodule may help to reduce inflammation

7.Surgery :
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Surgical opening of the synovial sheath may be necessary for tendon release.


What is the prognosis of Tenosynovitis?
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Prognosis is usually good although recurrence may occur after cortisone injection.

Surgery usually give excellent results.



































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