The difference between tendinitis and tendon sheath cyst.

Written by Lv Yao
Orthopedics
Updated on September 24, 2024
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Tendinitis refers to the inflammation of a sheath surrounding the tendon, known as the tendon sheath, caused by chronic strain. This results in a sterile inflammatory response between the tendon and its sheath, leading to symptoms such as pain and limited mobility. Meanwhile, a tendon sheath cyst is a cystic change occurring within the tendon sheath due to various reasons, characterized by a small amount of fluid or gel-like tissue within the cyst. When tendinitis occurs, it can be managed with conservative treatment, rest, and physical therapy to alleviate symptoms. On the other hand, a tendon sheath cyst might not show evident symptoms initially, but as the condition progresses and the cyst grows, it may compress local blood vessels or nerves causing symptoms, necessitating surgical intervention at this stage.

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Tendon sheath inflammation X-ray manifestations

Tendon sheath inflammation typically shows no noticeable abnormalities in the early stages on X-rays. However, in cases of recurrent constrictive tendon sheath inflammation, it may lead to abnormal changes in the local ligaments and joints, such as ectopic ossification, calcification, and bone proliferation. Generally, an X-ray examination of tendon sheath inflammation shows no significant local abnormalities. In stubborn cases, which relapse after multiple treatments, X-rays may reveal changes such as bony proliferation or ectopic ossification with high-density shadows.

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How to relieve tenosynovitis

Tendinitis is a chronic occupational disease that can cause inflammatory damage to the tendon and tendon sheath, leading to symptoms such as swelling and limited mobility. For the treatment of tendinitis, oral non-steroidal anti-inflammatory drugs can be taken, or topical ointments can be applied to the affected area to reduce inflammation and relieve pain, which can effectively alleviate the symptoms of tendinitis. It is also important to rest, and treatments such as heat application, physiotherapy, or local injections can be used. These methods can effectively improve symptoms and even achieve a cure. If conservative treatment is ineffective or if there is a functional impairment, minimally invasive procedures or surgery may also be considered.

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What causes tendinitis? How does tendinitis occur?

The cause of tenosynovitis is the repeated mechanical friction between the local tendon and tendon sheath, leading to chronic aseptic inflammatory changes. It is often related to repeated activity in the affected area. Excessive repetitive movement of the affected area causes local congestion, exudation, edema, and other inflammatory changes. The stimulation of inflammatory factors leads to local pain and discomfort. As the condition progresses, thickening of the tendon sheath causes the local tendon to move less smoothly within the sheath, thereby causing restricted local movement. Additionally, tenosynovitis in infants and young children is often considered to be caused by congenital factors.

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Orthopedics
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Is it good to get a steroid injection for tenosynovitis?

Treating tenosynovitis with injections is acceptable. Injections can significantly alleviate the pain caused by tenosynovitis and symptoms of limited joint mobility. However, it is imperative to take precautions during this treatment. Firstly, the injection contains steroids and anesthetics, so the number of injections must be limited. Generally, it is advisable to administer it once or twice a month. Excessive injections should be avoided as they can damage the local tendons or even the tendon sheaths, potentially exacerbating the pain from tenosynovitis or leading to spontaneous tendon ruptures. Therefore, the frequency of injections should be limited to a maximum of one to two times per month. Secondly, it’s crucial to ensure proper disinfection of the area during injections to prevent infections at the injection site and attend to potential bacterial infections. (Use of medication should be under the guidance of a physician.)

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How is tenosynovitis diagnosed?

Tendinitis mostly occurs in the wrist joints that frequently flex and extend, as well as in the thumb and corresponding metacarpophalangeal joints. It is largely due to the repetitive flexion and extension movements of the fingers and wrist joints, such as those performed by noodle makers in restaurants, vegetable cutters, and some handcraft laborers. Repeated movements irritate the local tendon sheaths causing inflammation, leading to relative narrowing, which prevents the tendons from flexing and moving normally. This results in a condition known as stenosing tendinitis. These are the common causes and symptoms of the condition, enabling a clear diagnosis.