Symptoms

The symptoms of tendosynovitis depend on the clinical course of the inflammation. In principle, an inflammation of the tendon sheath can occur anywhere in the body where tendon sheaths are located. It is usually found on the wrists or ankles.

Acute tendosynovitis occurs suddenly and manifests itself as swelling of the affected area. In addition, there is pain (pulling, stabbing) both at rest and during movement, as well as pain from pressure on the inflamed tendon sheath. In addition, reddening and overheating may be a sign of the inflammation.

If a tendon sheath inflammation occurs acutely, for example after heavy strain, a pressure pain along the tendon and muscle is typical. This pain is limited to the affected tendon sheath and is therefore also a diagnostic tool, as it is limited to the anatomical limits. The affected section is often reddened, overheated and swollen.

If further strain is placed on the affected section, pulling and stabbing pain occurs during movement. In very pronounced cases there is also pain at rest. Often this does not improve within one night, but needs a few days to subside.

Chronic tendosynovitis persists over a longer period of time and is usually milder than the acute form. Mostly nodular thickenings of the affected region develop, sometimes in connection with so-called crepitations when the tendon is palpated. Crepitations are crunching noises that can be heard when palpating the inflamed tendon sheath and are caused by protein deposits.

These are signs of the ongoing inflammation. Sometimes a painful, palpable “crunching” and rubbing over the affected tendon is noticeable. In some cases this “tendon crunching” is even audible and thus a clear sign of tendon sheath inflammation.

This rubbing can cause the phenomenon of the “fast finger” (tendovaginitis stenosans). In this case, the thickened tendon is initially stuck in the tendon sheath, but slides out of the constriction when the muscle pulls harder, causing the affected finger to suddenly snap forward. This phenomenon usually occurs with strong extension.

Most often, these thickenings are found in the area of the affected metacarpophalangeal joint on the palm of the hand. There is also pain during passive hyperextension of the affected tendon and during active tension against resistance. Both phenomena are found in the acute and chronic case of tendosynovitis and are also diagnostic tools.