How to diagnose tenosynovitis?

Written by Lv Yao
Orthopedics
Updated on December 09, 2024
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Tendinitis refers to the condition where the tendons and their sheaths, due to excessive flexing and extending activities, develop adhesion and exudation between each other, leading to a painful aseptic inflammatory response. Generally, when tendinitis occurs, there is restricted movement in flexing and extending, as well as localized pain symptoms. Moreover, tenderness is also pronounced in areas where tendinitis symptoms are evident. Therefore, the diagnosis of tendinitis can be made through symptoms and examination, and when necessary, ultrasound and MRI can be used to reflect local swelling and inflammatory responses.

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Written by Guan Jing Tao
Orthopedics
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How to reduce inflammation in tendinitis

To reduce inflammation in tendinitis, non-steroidal anti-inflammatory drugs (NSAIDs) should be used rather than antibacterial drugs such as cephalosporins, as the two are entirely different. In addition to using NSAIDs, it is also recommended to combine this with local physical therapy, such as electrotherapy, physiotherapy, acupuncture, etc. Topical NSAIDs can be applied locally and used in conjunction with physical therapy. For initial occurrences of tendinitis, these treatments can also provide good relief and improve symptoms of pain. However, for recurrent, stubborn tendinitis, the effectiveness of oral and topical medications in improving symptoms is limited. If necessary, local pain point block treatments can be performed, which can also result in good therapeutic effects. (The use of medications should be under the guidance of a doctor.)

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Written by Cheng Bin
Orthopedics
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How to treat tendon sheathitis?

This mainly depends on the severity of the patient's tendinitis, which determines the proactive treatment plan. For instance, if the tendinitis is very severe, with local snapping and limited flexion and extension movements, it is necessary to actively carry out treatments such as small-needle-knife surgery, tenosynovectomy, or partial excision surgery. However, for tendinitis that merely presents as pain symptoms, conservative treatment can still be chosen. For example, local injection, reducing physical activity, and insisting on daily local hot washing. Using some topical ointments that promote blood circulation and remove blood stasis, many patients will gradually recover through these active treatment methods.

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Written by Lv Yao
Orthopedics
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The difference between tendinitis and tendon sheath cyst.

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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Orthopedics
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Tendinitis mild and severe symptoms

Tendon sheath inflammation refers to the exudation and adhesion between the tendon and tendon sheath caused by excessive flexion and extension activities, resulting in a sterile inflammatory response with symptoms of localized pain and limited mobility. In the early stages of adhesive inflammation, there is severe pain in the affected area along with limited flexion and mobility. As the condition progresses and with increasing age, severe proliferation of the tendon sheath may cause compression on the tendon, leading to symptoms of constrictive tendon sheath inflammation, particularly in the extensor tendons of the index and thumb fingers, commonly known as trigger finger.

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Causes of tenosynovitis

The causes of tenosynovitis, simply put, the tendon sheath is a double-layered dense synovial tube that encases the tendons. It acts as a protective fluid sheath for the tendons, consisting of two layers enveloping the tendon. Between these two layers is a cavity filled with synovial fluid. The inner layer is closely attached to the tendon, while the outer layer lines the inside of the tendon fibrous sheath, jointly attaching to the bone. It primarily functions to stabilize, protect, and lubricate the tendons, preventing them from friction-induced damage and compression. Long periods of excessive friction can lead to damage in both the tendon and its sheath, leading to swelling and pain, which are the symptoms of tenosynovitis. For example, certain occupations such as bricklayers, carpenters, those who work extensively with computers, and chefs who frequently stir with spoons, as well as seamstresses in textile factories, are prone to developing tenosynovitis. There might be a link between this condition and occupational diseases. In such cases, applying heat can be helpful, and if the pain is particularly severe, enclosed treatments might be conducted. Additionally, taking drugs that promote blood circulation and relieve pain might be advisable. In severe cases, surgical treatment may be necessary. (The use of medications should be under the guidance of a doctor.)