Tendonitis or Tenosynovitis

Tendonitis (Tenosynovitis): Symptoms, Complaints, Signs

The following symptoms and complaints may indicate tenosynovitis: Leading symptoms Pressure pain Functional limitation Other symptoms Tendovaginitis stenosans (synonyms: tendovaginitis stenosans de Quervain; Quervain’s disease; Quervain’s tendovaginitis; “housewife’s thumb,” digitus saltans/rapid finger; snapping finger): bulging circumscribed tendon thickening proximal to the annular ligament; tendon nodules are palpable during flexion and extension of the fingerClinical presentation: … Tendonitis (Tenosynovitis): Symptoms, Complaints, Signs

Tendonitis (Tenosynovitis): Causes

Pathogenesis (development of disease) In tenosynovitis, inflammatory changes occur in the tendon sheath area. Etiology (causes) Biographic causes Hormonal factors Hormonal imbalance (menopause, oral contraceptives (“the pill”), pregnancy, lactation). Behavioral causes Chronic overuse of the joint Causes due to disease Gout (→ tendovaginitis as an expression of chronic gout). Rheumatic diseases Post-traumatic – for example, … Tendonitis (Tenosynovitis): Causes

Tendonitis (Tenosynovitis): Therapy

General measures Protection of the affected joint Local therapy with ice or cold compresses Avoiding the original load Conventional non-surgical therapy methods Analgesics (painkillers) Medical aids Bandages Physical therapy (including physiotherapy) Iontophoresis (also iontopheresis) – procedure for absorption of drugs through the skin using a weak direct electrical current.

Tendonitis (Tenosynovitis): Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin (normal: intact; abrasions/wounds, redness, hematomas (bruises), scars) and mucous membranes. Gait (fluid, limping). Body or joint posture (upright, bent, gentle posture). Malpositions (deformities, contractures, shortenings). Muscle atrophies (side … Tendonitis (Tenosynovitis): Examination

Tendonitis (Tenosynovitis): Drug Therapy

Therapeutic target Relief of symptoms Avoidance of functional limitations of the joint. Therapy recommendations Analgesia (pain relief) according to WHO staging scheme. Non-opioid analgesic (paracetamol, first-line agent). Low-potency opioid analgesic (e.g., tramadol) + non-opioid analgesic. High-potency opioid analgesic (eg, morphine) + non-opioid analgesic. If necessary, anti-inflammatory drugs / drugs that inhibit inflammatory processes (non-steroidal anti-inflammatory … Tendonitis (Tenosynovitis): Drug Therapy

Tendonitis (Tenosynovitis): Diagnostic Tests

Obligatory medical device diagnostics. Sonography (ultrasound examination) of the affected region – to confirm the diagnosis. Optional medical device diagnostics – depending on the results of the history, physical examination and obligatory laboratory parameters – for differential diagnosis. Magnetic resonance imaging (MRI) – computer-assisted cross-sectional imaging method (using magnetic fields, i.e., without X-rays); particularly well … Tendonitis (Tenosynovitis): Diagnostic Tests

Tendonitis (Tenosynovitis): Surgical Therapy

The indication for surgical therapy in tenosynovitis is when there is severe calcification and/or severe functional impairment. Furthermore, in a chronic course, if treatment does not result in improvement of symptoms after 4-6 months, surgery should be considered. Surgical measures In “snapping finger“, surgical splitting of the A1 annular ligament at the level of the … Tendonitis (Tenosynovitis): Surgical Therapy

Tendonitis (Tenosynovitis): Medical History

Medical history (history of illness) is an important component in the diagnosis of tenosynovitis (tendonitis). Family history Social history What is your occupation? Current medical history/systemic history (somatic and psychological complaints). What symptoms have you noticed? Pressure pain Functional limitations Since when do these changes exist? (eg after overload / an accident). Do the changes … Tendonitis (Tenosynovitis): Medical History

Tendonitis (Tenosynovitis): Or something else? Differential Diagnosis

Musculoskeletal system and connective tissue (M00-M99). Tenovaginitis stenosans (synonyms: tendovaginitis stenosans de Quervain; Quervain’s disease; Quervain’s tendovaginitis; “housewife’s thumb,” digitus saltans/snapping finger; snapping finger) – this is a constricting tendovaginitis; in tendovaginitis stenosans de Quervain, the tightness is localized to the 1st extensor tendon compartment. Tendovaginitis stenosans de Quervain (also called housewife’s thumb), can result … Tendonitis (Tenosynovitis): Or something else? Differential Diagnosis