Finestone Test

In the so-called Finkelstein test, the doctor grasps the patient’s thumb and tries to move the hand quickly in the direction of the ulna. If a tendovaginitis is present, strong pain in the area of the radius occurs. During the Eichhoff test, the patient is asked to place the thumb of the aching hand on the palm of the hand and enclose it with the other fingers.

Afterwards the hand is moved by the doctor in the direction of the little finger. Patients with tendovaginitis report intense pain radiating into the arm during this test. In addition to the description of the symptoms, information about professional activity and possible leisure activities is also of great importance.

Office workers, musicians and athletes tend to suffer from tendovaginitis much more frequently. The second step in the diagnosis of tendovaginitis is the physical examination of the patient. By palpation of the affected body region, the pain usually increases in intensity.

In addition, so-called “crunching noises” can often be detected when moving the affected joint, which are caused by rubbing the inflamed tendon sheath over the bone. If the findings are unclear, it may also be necessary to initiate further examinations. In addition to the physical findings and symptoms, a blood test can be used to detect special inflammation markers.

In the presence of tendovaginitis, the blood contains mainly elevated white blood cells and CRP values. In addition to the classic signs of inflammation, blood analysis with detection of a special rheumatoid factor also provides information about the diagnosis. The preparation of an X-ray or an MRI (magnetic resonance imaging) can also be useful in the diagnosis of tendovaginitis.

Therapy

The choice of the appropriate therapy for tendovaginitis depends primarily on its causes. Infectious forms usually require antibiotic treatment, whereas non-infectious types require relief, pain relief and physiotherapy. Furthermore, the therapy of tendovaginitis depends on the extent as well as on the frequency with which the symptoms occur.

For the majority of the affected patients, a drug therapy is completely sufficient to eliminate the symptoms. Especially such painkillers (analgesics), which belong to the class of non-steroidal anti-inflammatory drugs, can help to effectively relieve the stabbing pain in the area of the affected joint. When choosing an analgesic, anti-inflammatory drugs should be the means of choice.

In addition to relieving pain, these are able to contain the course of the disease and bring about a rapid recovery of the tendon sheaths. In addition to pain relief, immobilization of the affected joint also plays a significant role in tendovaginitis therapy. The application of supporting bandages and the use of anti-inflammatory ointments or creams is considered helpful by most patients.

In case of chronic forms of tendovaginitis or patients who frequently suffer from tendovaginitis, it may be necessary to adjust a so-called chain splint. A warp splint is a splint adapted to mechanical stress symptoms, which alleviates the symptoms of external compression of the affected area. A further point not to be neglected in the treatment of tendovaginitis is the adjustment of the working conditions.

Patients who work a lot with computers should change over to ergonomic keyboards and mice. Ultimately, the non-infectious forms of tendovaginitis can only be counteracted by reducing false and excessive strain. In the case of chronic forms of tendovaginitis, the use of local anesthetics or preparations containing cortisone can also be considered. Surgical correction of the tendon sheath apparatus is rarely necessary. This treatment option mainly concerns those patients in whom no or only a slight improvement of the pain problem is achieved despite adequate pain therapy and a change in life circumstances.By splitting the affected tendon sheath, a permanent relief of tendovaginitis symptoms can be guaranteed in most cases.