tenosynovitis

What is Tenosynovitis?

Tenosynovitis is an inflammatory condition that affects the tendons and their surrounding sheaths in the body. It occurs when the synovial membrane, a protective layer of tissue, becomes inflamed due to various reasons such as injury, infection, or overuse.

Causes and Types

• Tenosynovitis can be caused by acute or chronic inflammation, and it can affect any tendon in the body.
• There are different types of tenosynovitis, including flexor tenosynovitis (FT), which involves disruption of normal tendon function [2].
• De Quervain's tenosynovitis is a specific type that affects the tendons on the thumb side of the wrist and attach to the base of the thumb [6].

Symptoms

• Pain and stiffness in the affected area are common symptoms of tenosynovitis.
• Swelling, reddening, and sensitivity to pressure can also occur [7].
• In severe cases, pyogenic flexor tenosynovitis can cause infection of the synovial sheath surrounding the flexor tendon [8].

Treatment

• Treatment for tenosynovitis typically involves rest, ice, and physical therapy to reduce pain and inflammation.
• A splint or brace can be used to rest the affected tendons [4].
• In some cases, antibiotics may be prescribed if the condition is caused by an infection.

References:

[1] - Tenosynovitis is characterized by inflammation involving the synovial sheath of a tendon. It can have various causes, including inflammatory conditions. [2] - Most acute cases of flexor tenosynovitis (FT), which involves disruption of normal tendon function, are caused by inflammation of the protective sleeve of tissue surrounding your tendons. [3] - Tendons are the cords of tissue that connect muscles to bones and are surrounded by a synovial membrane. [4] - A splint or brace can rest the affected tendons and help reduce pain and inflammation. [5] - Tenosynovitis is an inflammatory condition that affects the tendons and their surrounding sheaths in the body. [6] - De Quervain's tenosynovitis is a specific type of tenosynovitis that affects the tendons on the thumb side of the wrist and attach to the base of the thumb. [7] - Tenosynovitis in the hand or wrist manifests initially as pain during gripping or movement. Swelling, reddening, and sensitivity to pressure aren't uncommon symptoms. [8] - Pyogenic flexor tenosynovitis is an infection of the synovial sheath that surrounds the flexor tendon. [9] - Tenosynovitis is characterized by inflammation involving the synovial sheath of a tendon. It can have various causes, including inflammatory conditions.

Common Signs and Symptoms of Tenosynovitis

Tenosynovitis, an inflammation of the synovial membrane surrounding a tendon, can manifest in various ways depending on the location and cause of the condition. Here are some common signs and symptoms:

• Pain: Pain is a primary symptom of tenosynovitis, often described as a dull ache or sharp pain in the affected area [1][2].
• Swelling: Swelling can occur around the tendon, making it visible or palpable [3][5].
• Limited Movement: Tenosynovitis can lead to stiffness and limited movement in the affected joint or limb [6].
• Tenderness: Tenderness along the flexor tendon sheath is a common sign of tenosynovitis [4].

Specific Symptoms

In some cases, tenosynovitis can cause more specific symptoms, such as:

• Pain near the base of the thumb: De Quervain's tenosynovitis often presents with pain near the base of the thumb [7][8].
• Swelling near the base of the thumb: Swelling in this area is also a common symptom of De Quervain's tenosynovitis [7].

Other Possible Symptoms

In addition to these symptoms, tenosynovitis can also cause:

• Finger pain or discomfort
• Wrist pain or stiffness
• Knee pain or stiffness
• Ankle pain or stiffness

It is essential to consult a healthcare provider if you experience any of these symptoms, as they can help determine the underlying cause and provide proper treatment.

References: [1] - Context 2 [2] - Context 5 [3] - Context 5 [4] - Context 4 [5] - Context 5 [6] - Context 6 [7] - Context 8 [8] - Context 9

Diagnostic Tests for Tenosynovitis

Tenosynovitis, an inflammation of the tendon sheath, can be diagnosed through various tests. Here are some common diagnostic tests used to diagnose tenosynovitis:

• Physical Exam: A healthcare provider will typically perform a physical exam to diagnose tenosynovitis [2]. They will check your symptoms and range of motion (how far you can move a part of your body) [3].
• Finkelstein Test: This test is used in the diagnosis of De Quervain's syndrome, which is a type of tenosynovitis that affects the tendons on the thumb side of the wrist [8]. The test involves bending the wrist and moving the thumb away from the palm.
• Eichhoff Test: Similar to the Finkelstein test, this test also diagnoses De Quervain's syndrome. If you experience pain during the maneuver, it may indicate that you have tenosynovitis [4].
• Wrist Hyperflexion and Abduction of the Thumb (WHAT) Test: This is a more specific and sensitive test to diagnose de Quervain tenosynovitis than the Eichhoff's Test [5]. The test involves bending the wrist and moving the thumb away from the palm.
• High-Resolution Ultrasound Scan: If required, a high-resolution ultrasound scan can be used to diagnose tenosynovitis. This is considered the most accurate investigation for diagnosing this condition [7].

It's worth noting that imaging tests such as X-rays are generally not needed to diagnose de Quervain tenosynovitis [1]. A healthcare provider will typically use a combination of these tests to make an accurate diagnosis.

References: [1] Aug 4, 2022 — Imaging tests, such as X-rays, generally aren't needed to diagnose de Quervain tenosynovitis. [2] Your healthcare provider will diagnose tenosynovitis with a physical exam. They will check your symptoms and your range of motion (how far you can move a part ... [3] A healthcare provider will diagnose de Quervain's tenosynovitis with a physical exam. They'll examine your thumb and wrist. [4] The test is positive, indicating you may have De Quervain's tenosynovitis, if you experience pain during the maneuver. [5] The wrist hyperflexion and abduction of the thumb (WHAT) test: a more specific and sensitive test to diagnose de Quervain tenosynovitis than the Eichhoff's Test ... [7] Jul 23, 2024 — Diagnosis is usually clinical. If required, the single most useful and accurate investigation is a high-resolution ultrasound scan. [8] The Finkelstein test is used in the diagnosis of De Quervain's syndrome. This fact implies a tenovaginitis and tenosynovitis of the M. extensor pollicis brevis ...

Based on the available information, it appears that drug treatment for tenosynovitis can vary depending on the underlying cause and severity of the condition.

Medications used to treat tenosynovitis

• For rheumatoid inflammatory flexor tenosynovitis, treatment may include medications such as:
  • Hydroxychloroquine [2]
  • Gold [2]
  • Penicillamine [2]
• In some cases, antibiotics may be prescribed if the condition is caused by an infection. Empirical antibiotics used to treat infectious tenosynovitis may include vancomycin 15-20 mg/kg/day [4]

Other treatments

• Rest and immobilization of the affected area are often recommended as initial treatment for de Quervain tenosynovitis [1]
• Applying heat or cold to the affected area can help reduce pain [5,6]
• Changing activities, icing the area, and using a splint to limit movement may also be suggested [7]

Surgical options

• In some cases, surgery may be necessary to treat de Quervain's tenosynovitis. This is usually an outpatient procedure [8]

It's essential to consult with a healthcare professional for personalized advice on treating tenosynovitis, as the most effective treatment plan will depend on individual circumstances.

References: [1] Context result 1 [2] Context result 2 [4] Context result 4 [5] Context result 5 [6] Context result 6 [7] Context result 7 [8] Context result 8

Differential Diagnosis of Tenosynovitis

Tenosynovitis, an inflammation of the tendon sheath, can be caused by various factors. The differential diagnosis of this condition is crucial to determine the underlying cause and provide appropriate treatment.

Common Differential Diagnoses:

• Cellulitis: A bacterial skin infection that can mimic symptoms of tenosynovitis, making it challenging to diagnose.
• Joint-related diseases: Conditions such as osteoarthritis, rheumatoid arthritis, and pseudogout can cause similar symptoms to tenosynovitis.
• Infective causes: Bacterial infections like pyogenic flexor tenosynovitis can lead to inflammation of the tendon sheath.
• Mechanical stress-related conditions: De Quervain's tenosynovitis and trigger finger are two common forms of stenosing tenosynovitis, which occur due to mechanical stress on the tendons.

Other Differential Diagnoses:

• Rheumatoid arthritis: An autoimmune disease that can cause inflammation in the joints and surrounding tissues.
• Psoriatic arthritis: A type of arthritis that occurs in people with psoriasis, causing inflammation in the joints and surrounding tissues.
• Calcium pyrophosphate dihydrate crystal deposition disease: A condition characterized by the accumulation of calcium crystals in the joints, leading to inflammation.

Clinical Evaluation

The diagnosis of tenosynovitis is primarily clinical, based on a thorough history and physical examination. The evaluation process involves identifying symptoms such as pain, swelling, and limited mobility in the affected area. Imaging studies like ultrasound or X-rays may be used to rule out other conditions that can mimic tenosynovitis.

References:

• [3] Differential diagnosis of tenosynovitis of the wrist include rheumatoid arthritis, psoriatic arthritis, infectious tenosynovitis (may occur by haematogenous seeding or through puncture wounds) and calcium pyrophosphate dihydrate crystal deposition disease.
• [5] The common differential diagnosis of the condition is cellulitis and joint-related diseases. In cellulitis the condition may mimic tenosynovitis, making it challenging to diagnose.
• [10] A variety of diseases may mimic or contribute to tenosynovitis; common examples appear below. Cellulitis/soft tissue infection may mimic symptoms of tenosynovitis, resulting in difficulty moving the affected joint from edema and pain.

Note: The numbers in square brackets refer to the search results provided in the context.