Tendosynovitis
(Internal Disease - Joints tissue)
Tendosynovitis - diseases of tendons and tendon sheaths. Generally affecting the extensor tendons of the muscles of hand and foot going through the narrow bone-fibrous feeds. As a consequence, the tendons exposed to minor trauma that leads to the development of the synovial membrane of a small tendon inflammation, which later can turn into chronic and lead to compaction and stenosis of the tendon.
Tendosynovitis of the hands develops mainly in women engaged in manual labor (dressmakers, typists, pianists, etc.). Is usually found in the long adductor tendon and the short extensor muscle of thumb, which manifests itself with pain in the area subulate appendages radiating to the thumb and the outer surface of the forearm. Pain intensifies under pressure, as well as abduction and extension of the thumb. Movement in the radiocarpal joint is free and painless. When moving the thumb and the wrist sometimes hear a small, dull crackling. In the transition to a chronic form develops chronic constrictive tendovaginitis (de Quervain’s disease) with fibrosis of the tendon and the formation of subulate appendages oblong, dense, sedentary and painless swelling. Movement of the thumb sharply painful. The X-ray sometimes with small Haygarth’s nodes in the subulate appendages radius.
Current chronic disease with a duration of several weeks to several months, and then (especially after wrist immobilization in a plaster bus) usually comes healing.
Tendosynovitis of the foot is rare. Arises as a result of microtrauma, cooling, muscle overexertion, vasomotor disturbances. Most often affects the tendons of the long common extensor of the fingers and anterior tibial muscles. In mild form, there are only a small hyperemia, but clinically small embarrassment and mild crepitus with motion in the foot. In the formation of effusion arises oblong painful, sometimes fluctuating swelling along the tendon. The course is favorable, but sometimes synovitis may pass into the chronic form. In these cases, the motion of the foot are difficult and painful on palpation feel the thickened tendon and sealed.
Recognition. Based on the presence of pain while reducing the individual muscle tendons, and these pains are localized outside the joint, passive movements which are usually free and painless. It is also probing compacted and painful tendons. For the differential diagnosis in relation to arthritis, it is important to the absence of inflammation in the joint (periarticular tissue swelling, effusion in the joint cavity, his pain on palpation and movement) and normal X-ray of the joint.
Treatment. Immobilization of the joint, the best in the cast. For pain use analgesics (Acetylsalicylic acid, Dipyrone and others), radiotherapy, local Hydrocortisone or Procaine (injections). In the absence of improvement (fibrosis tendon) is recommended surgery.
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