Tenosynovitis (infectious, purulent, crepitant)

Tenosynovitis

Tenosynovitis is an inflammation of the tendon and its surrounding membranes, also known as synovial membranes.
Some tendons are covered with synovial membranes, but some tendons are not covered. The synovium produces a small amount of oily fluid that is secreted into the space between the tendon and its synovium. This oily fluid helps the tendon move easily and without resistance when the bone to which the tendon is attached moves. Common signs of tenosynovitis are pain, swelling and tenderness in the joint area. In most cases, it is necessary to sharply reduce movement in the inflamed joint to allow for faster recovery. Often, the pain lasts for several days and disappears without any treatment. But in other cases, pain and swelling persist for many months, especially if no treatment is given.

Any tendon in the human body can be susceptible to tenosynovitis, but there are certain areas that are most susceptible to this pathology. For example, the hand and wrist, since they are often used to perform the same type of repetitive movements.

While there is no actual evidence to suggest what exactly can prevent tenosynovitis from occurring, it is still recommended to avoid repetitive movements as much as possible. Nowadays, there are certain exercises to strengthen the muscles surrounding the damaged tendons.

Diagnostics

The most informative method of differential diagnosis is radiography. It allows you to exclude osteomyelitis, arthrosis, and all types of arthritis. The study is carried out to identify the localization of inflammation, its stage and course. CT or MRI are prescribed to patients to obtain images with clear visualization of the tendon, its sheath, ligamentous-muscular apparatus, and blood vessels. The images clearly show the developed complications of the inflammatory-degenerative pathology.

If an infectious nature of finger tendonitis is suspected, biochemical and serological studies and bacterial cultures are carried out. They help not only to establish the type of microorganism, but also its sensitivity to antibiotics.

Tendonitis

Inflammation of the tendon is called tendonitis. This is a general term that refers to damage to a tendon, the fibrous tissue that attaches muscles to bones. The term tendonitis applies to all tendons in the body. For example, “tennis elbow” (inflammation in the elbow area), patellar tendonitis (inflammation of the tendon in the knee area), Achilles tendonitis (inflammation of the Achilles tendon), etc.

Tendonitis can occur in people of all ages, predominantly in the extremities, both upper and lower. The time required for recovery varies and depends on the degree of damage to the tendon. The inflammation usually affects the upper and lower extremities, but may occur in the shoulder or fingers.

Mainly, tendonitis occurs from repetitive movements and after physical activity (sports). Stiffness and pain are often intense, especially during and after exercise, as exercise increases inflammation in a tendon already damaged by repetitive motion. Standard treatment is usually aimed at immobilization and cold on the area of ​​inflammation, often without identifying the causes of the disease. Early treatment helps avoid chronicity of the process.

Aseptic (crepitating) form of the disease

The development of this form of the disease is caused by a lack of synovial fluid, which causes increased friction between the layers of the tendon sheath. An accumulation of serous or hemorrhagic exudate occurs in the capsule cavity. With proper and timely treatment, the exudate is converted into fibrinous, which indicates the beginning of regeneration.

However, clinicians have proven that in most cases, first-time aseptic tenosynovitis, treated incorrectly or insufficiently, develops into a chronic form. This can be explained by the formation of a large number of adhesions inside the capsule and the replacement of cells that form the synovial fluid with connective tissue.

Causes of tendonitis

Typical tendonitis is caused by excessive stress on the tendon through repetitive movements against resistance (racquet play, jumping). Although the body tries to compensate for tendon tears, regeneration does not keep up with ongoing stress. Consequently, layering of loads increases trauma and increases pain.

With age, the elasticity of tendons decreases. In addition, concomitant diseases (such as diabetes, rheumatoid arthritis, tuberculosis) also reduce the strength and elasticity of the tendons.

Tendonitis causes inflammation of the tendon and can also be associated with the nature of the job (work as a mechanic or mechanic).

Athletes are most at risk of developing tendonitis, since there are quite a lot of repetitive movements in this type of activity.

Baseball players often throw baseballs, which can cause injuries to the wrists and shoulders. Golfers may have tendonitis in their knuckles. Basketball players who have to jump frequently are susceptible to patellar tendonitis and Achilles tendonitis. But not only excessive loads can cause tendonitis. The main thing is the presence of a large number of repetitive movements. Therefore, tendonitis can occur in artists and musicians.

Prevention

To summarize, we see that the occurrence of wrist tenosynovitis is often associated with monotonous movements performed daily. For example, related to professional activities. Therefore, the main measure to prevent the disease is:

• organizing short breaks from work. At this time, it is necessary to do exercises for the hands. Moreover, shaking the brushes has proven to be excellent. Shaking the brushes, as well as circular movements in the hands, are famous for good results. You can also extend and bend your fingers.
• change or alternation of activities.
• regular massage course. You can produce it yourself. Moreover, it will help relieve swelling. In addition, it will improve blood circulation.

Be attentive to your health. Moreover, tenosynovitis of the wrist joint can be prevented if prevention is performed regularly.

More useful information here

Symptoms of tendonitis

Signs of tendonitis may appear immediately or develop gradually. Characteristic is the presence of pain, which can be mild, aching or burning and radiating to the nearest muscles, ligaments, and bones.

Symptoms such as stiffness may also appear, as movement is impaired due to damage. Sometimes the joint does not bend. It is also possible that swelling and pain will occur in the area of ​​the damaged tendon. Various sounds may occur when the joint moves.

Symptoms of tendonitis vary and depend on the joint involved. People with patellar tendonitis have difficulty walking up and down stairs. They also have a hard time walking long distances. While patients with tennis elbow have difficulty grasping a doorknob to open or close a door, eating food also becomes more difficult because they are unable to hold a spoon, fork, or cup properly.

If symptoms such as redness, swelling, fever, or deformation in the joint area appear, it is recommended to consult a doctor immediately. Often such symptoms indicate chronic tendonitis. Chronic tendonitis is a source of constant pain that interferes with a normal lifestyle (performing normal housework). Consultation with a doctor is necessary in order to avoid irreversible changes if the tendon is damaged.

Diet

Diet for sore joints

• Efficacy: therapeutic effect after 2-3 months
• Terms: 2-6 months
• Cost of products: 1700-1800 rubles. in Week

During the period of illness and recovery after it, the diet should be such as to strengthen the tendons. For this purpose, it is recommended to introduce the following products into the diet:

• beef;
• jelly and jellied meat;
• jellied fish;
• dishes containing gelatin;
• liver;
• dairy products;
• apricots, citrus fruits;
• nuts;
• Bell pepper.

It is recommended to drink green tea with ginger.

In general, the diet should be rich in calcium, iodine, iron, phosphorus, vitamins A, C, D, E. All these substances help strengthen the tendons.

Treatment of tendonitis and tendovaginitis

Currently, there is no clear method for treating tendovaginitis or tendonitis . The set of recommended measures is as follows.

• Peace. It is necessary to limit movement in the limb with damaged tendon. For this purpose, various types of orthoses can be used. For example, fixing the hand with an orthosis helps to significantly reduce the load on the tendons.
• Application of cold. You can cover the damaged area with an ice pack for 10-15 minutes daily. The effect of cryotherapy is much better. Exposure to cold reduces swelling and reduces pain.
• Analgesics. Often prescribed to relieve pain and inflammation (for example, ibuprofen). However, inflammation may not be the main cause of tendonitis or tenosynovitis. However, analgesics help reduce pain. In addition, there are ointments and gels with analgesic that can be applied topically.
• Antibiotics. Necessary in case of an infectious process.
• Injections of steroids into the affected area are recommended if other treatment measures are ineffective.
• Physiotherapy. It has a good effect, reduces inflammation, stimulates regeneration.
• Autohemotherapy. In the past, it was quite often used to treat such diseases (nowadays, it is rarely used).
• Shock wave therapy. The use of a focused sound wave has a good effect by stimulating reparative processes.
• Surgical treatment is rarely used.
• Physiotherapy. It is used only after pain has decreased. Allows you to strengthen the muscles in the area of ​​the damaged tendon.

Septic (infectious) form of the disease

Septic tenosynovitis in most cases is provoked by the presence of an inflammatory (and often purulent) focus near the tendon tissue. Depending on the underlying disease that caused the development of the pathology. The following types of infectious tendovaginitis can be distinguished:

Nonspecific - caused mainly by panaritium, acute purulent arthritis, phlegmon, osteomyelitis, the foci of which are in close proximity to the tendon.

Specific - the cause is brucellosis, syphilis, gonorrhea, tuberculosis, the pathogens of which enter the cavity of the synovial vagina through the bloodstream.

Septic tenosynovitis is only purulent and often requires surgical treatment.

Folk remedies

Remedies made according to recipes from traditional healers are effective during the rehabilitation period. After the main treatment, warming up the damaged tendon is practiced to accelerate its healing. Linen bags with drawstrings filled with hot sea salt or flaxseeds are used. For warming, a homemade rub is also used:

• a dark glass container is filled to the top, without compacting, with freshly picked leaves of burdock, plantain, sorrel, dandelion flowers, calendula, chamomile, finely chopped horseradish roots;
• carefully pour vodka without additives or 96% ethyl alcohol diluted with an equal volume of water along the wall;
• Place for a month in a warm, dark place, shake periodically.

Alcohol tincture of herbs.

The resulting tincture is rubbed on the forearm 1-3 times a day. Biologically active substances transferred into an alcohol solution have an analgesic, anti-inflammatory and blood circulation-improving effect.

In the absence of medical intervention, the pathology gradually takes on a chronic form. Painful sensations occur during physical exertion, after hypothermia, or during a sharp decrease in immunity. The biceps and deltoid muscles begin to weaken and atrophy, reducing the functional activity of the arm. Fibroplastic tendomyositis develops, in which irreversible fibrous degeneration of the tendon occurs. You can avoid such negative developments by seeking medical help when the first pathological signs appear.

Classification

When choosing a treatment method, doctors take into account the form of diagnosed tenosynovitis of the forearm. The most severe is a purulent pathology that develops as a result of tissue infection. It is characterized by the accumulation of purulent exudate in the tendon vagina, provoking a rapid worsening of symptoms and the spread of the inflammatory process to healthy areas. Serous tenosynovitis of the forearm is also isolated, in which the inner layer of the membrane is affected and a transparent protein-serous serum is released. Less common is a serous-fibrous disease, which occurs against the background of the formation of a specific plaque and the accumulation of serous exudate. The treatment methods used also depend on the form of the pathology:

• initial. There is hyperemia (overflow of blood vessels) of the synovial vagina, accumulation of perivascular infiltrate, usually localized in the outer membrane;
• exudative-serous. A small amount of effusion is detected in the tendon sheath, and the clinical picture is complemented by the formation of a small round swelling in the inflamed part of the tendon;
• stenosing. Sclerotic changes occur: the structures of individual layers are smoothed, the canal of the synovial vagina is partially or completely narrowed.

Tenosynovitis of the forearm can be aseptic or infectious, chronic or acute. There are primary diseases that develop after tendon injury. Secondary tendovaginitis occurs due to pathology already present in the body: arthritis, arthrosis, venereal, respiratory, intestinal infections.

The main cause of tendovaginitis is microtrauma.