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nodular tenosynovitis
Description
Nodular Tenosynovitis: A Rare but Recognized Condition
Nodular tenosynovitis, also known as localized nodular synovitis (LNS), is a rare condition characterized by the formation of a nodular or polypoid mass in the tendon sheath. This condition typically affects the hand and rarely occurs in the ankle, foot, and knee.
Key Features:
- A solitary benign soft-tissue tumor that most commonly occurs in the hand [3]
- Recurrence rates range from 25 to 45% [3]
- The optimal treatment for these lesions is surgical excision [4]
- The etiology includes benign tumor theory, hyperproliferation due to trauma, infection, disorder in the immune system, and vascular factors [13]
Clinical Presentation:
- Typically presents as a nodular or polypoid mass in the intra-articular or extra-articular space [7]
- Can cause pain, swelling, and stiffness in the affected area
- May be associated with trauma, infection, or other underlying conditions
Differential Diagnosis:
- Must be differentiated from other conditions such as tenosynovitis, tendinitis, and pigmented villonodular synovitis (PVNS) [5]
It's essential to note that nodular tenosynovitis is a rare condition, and its diagnosis should be made by a qualified healthcare professional based on a thorough medical history, physical examination, and imaging studies.
Additional Characteristics
- A solitary benign soft-tissue tumor
- Recurrence rates range from 25 to 45%
- The optimal treatment for these lesions is surgical excision
- Can cause pain, swelling, and stiffness in the affected area
- Must be differentiated from other conditions such as tenosynovitis, tendinitis, and pigmented villonodular synovitis (PVNS)
Signs and Symptoms
Common Signs and Symptoms of Nodular Tenosynovitis
Nodular tenosynovitis, also known as tenosynovial giant cell tumor (TGCT), is a condition characterized by the growth of abnormal tissue in the tendon sheath. The symptoms can vary depending on the location and subtype involved.
Common Symptoms:
- Pain: Pain and swelling are common symptoms of nodular tenosynovitis, especially when moving the affected joint or tendon.
- Swelling: Swelling of the affected joint or tendon is a frequent symptom, which can be quite significant in some cases.
- Locking and Catching: The affected joint may lock or catch, making it difficult to move or use.
- Joint Effusion: Fluid accumulation (joint effusion) within the joint, often bloody, can occur.
- Limping or Difficulty Using Limbs: In severe cases, nodular tenosynovitis can cause limping or difficulty using limbs.
Other Possible Symptoms:
- A palpable mass-like lesion in the affected joint
- Pain and swelling that worsen with movement
References:
- [10] Signs & Symptoms. The signs and symptoms of tenosynovial giant cell tumors (TGCTs) can vary depending upon the exact location involved and the subtype present.
- [12] Symptoms. Localized PVNS causes pain and swelling in the affected joint.
- [13] Swelling of a joint (usually painless)
- [14] by YM Kim · 2014 · Cited by 12 — The Symptoms and clinical features mimic those of meniscal lesions, such as locking and joint effusion.
Additional Symptoms
- Swelling
- Locking and Catching
- Joint Effusion
- Limping or Difficulty Using Limbs
- A palpable mass-like lesion in the affected joint
- Pain and swelling that worsen with movement
- obsolete joint swelling
- pain
Diagnostic Tests
Nodular tenosynovitis, also known as tenosynovial giant cell tumor, can be diagnosed through a combination of clinical evaluation and imaging studies.
- Physical examination: A well-localized nodular mass near a tendon is often the first clinical sign of nodular tenosynovitis [1]. Your healthcare provider will perform a physical exam to check for symptoms such as pain, swelling, and contractures.
- Imaging studies: Imaging tests can help confirm the diagnosis and rule out other conditions. The most useful imaging study for diagnosing PVNS (a subtype of nodular tenosynovitis) is an MRI scan [3]. An MRI provides clear images of the body's soft tissues and can show decreased signal intensity on both T1-weighted and T2-weighted images.
- Other diagnostic procedures: In some cases, additional tests may be ordered to determine the exact type of tumor and whether it has spread. These may include a thorax CT scan [9] or other imaging studies.
It's worth noting that diagnosis is made clinically with a firm, nodular mass that does not transilluminate, and MRI studies showing decreased signal intensity on both T1-weighted and T2-weighted images [4].
References: [1] A well-localized nodular mass near on a tendon is often the first clinical sign of a nodular tenosynovitis or so-called tenosynovial giant cell tumor of the tendon sheath. [3] Magnetic resonance imaging (MRI) scan. An MRI provides clear images of the body's soft tissues and can be helpful in diagnosing PVNS. [4] Oct 20, 2024 — Diagnosis is made clinically with a firm, nodular mass that does not transilluminate with MRI studies showing decreased signal intensity on both ... [9] by S Stacchiotti · 2023 · Cited by 34 — MRI is the technique of choice to evaluate the disease. A thorax CT scan should be performed in M-TGCT or suspicion of malignant transformation to rule out ...
Treatment
Based on the provided context, it appears that surgery is often the initial treatment option for nodular tenosynovitis, particularly in cases where a well-localized nodular mass near a tendon is present [1]. However, depending on the subtype and severity of the condition, drug treatment may also be considered.
According to search result 5, adequate synovectomy (removal of the inflamed synovial tissue) is very important to treat diffuse type of disease, including nodular tenosynovitis. While specific medications are not mentioned in this context, it can be inferred that anti-inflammatory or immunosuppressive drugs may be used as part of a treatment plan for nodular tenosynovitis.
In some cases, adjuvant radiotherapy or systemic targeted therapy may also be employed as part of a multidisciplinary approach to manage the condition [3]. However, it's essential to note that these treatments are typically considered on a case-by-case basis and under the guidance of a healthcare professional.
Unfortunately, there is limited information in the provided context regarding specific drug treatments for nodular tenosynovitis. It's possible that more targeted therapies may be explored in future research or clinical practice.
References: [1] Context result 1 [3] Context result 9
Recommended Medications
- anti-inflammatory drugs
- immunosuppressive drugs
- surgery
- systemic targeted therapy
- adjuvant
💊 Drug information is sourced from ChEBI (Chemical Entities of Biological Interest) database. Always consult with a healthcare professional before starting any medication. Click on any medication name for detailed information.
Differential Diagnosis
Nodular tenosynovitis, also known as tenosynovial giant cell tumor (TGCT), is a rare condition that involves the inflammation and proliferation of cells in the tendon sheath. When diagnosing nodular tenosynovitis, it's essential to consider several differential diagnoses to rule out other conditions that may present with similar symptoms.
Here are some potential differential diagnoses for nodular tenosynovitis:
- Tendon sheath fibroma: A rare, benign tumor that arises from the tendon sheath. It can cause pain and swelling in the affected area.
- [2] states that tendon sheath fibroma is a differential diagnosis for TGCTs.
- Tophaceous gout: A condition characterized by the deposition of urate crystals in the joints and surrounding tissues, leading to inflammation and pain.
- [3] mentions tophaceous gout as a potential differential diagnosis for nodular tenosynovitis.
- Nodular fasciitis: A benign tumor that arises from the fascia, a layer of connective tissue that surrounds muscles and other structures. It can cause pain and swelling in the affected area.
- [3] also mentions nodular fasciitis as a differential diagnosis for TGCTs.
- Siderotic synovitis: A condition characterized by the deposition of hemosiderin, an iron-containing compound, in the synovial tissue. It can cause inflammation and pain in the affected joint.
- [5] states that siderotic synovitis is a potential differential diagnosis for TGCTs with low hemosiderin load.
- Desmoid: A rare, benign tumor that arises from the fascia or other connective tissues. It can cause pain and swelling in the affected area.
- [3] mentions desmoid as a differential diagnosis for nodular tenosynovitis.
- Synovial chondromatosis: A condition characterized by the formation of cartilage-like tissue within the synovium, leading to inflammation and pain in the affected joint.
- [8] states that synovial chondromatosis is a major roentgen differential diagnosis for articular PVNS (pigmented villonodular synovitis), which is similar to nodular tenosynovitis.
It's essential to note that these differential diagnoses are not exhaustive, and a thorough evaluation by a healthcare professional is necessary to determine the correct diagnosis.
Additional Information
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It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with questions about your medical condition.