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 Yu Hua
Orthopedic Surgery
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Causes of recurrence of wrist tenosynovitis

Tendinitis is most commonly seen in the wrist or metacarpophalangeal joints. Typically, patients will experience redness, swelling, heat, and tenderness in the wrist, along with limited joint mobility. It is usually recommended that patients rest and avoid overexertion. Due to repeated friction caused by overexertion, swelling of the annular ligament or tendon sheath can occur. This leads to insufficient circulation of synovial fluid within the joints, and excessive friction can cause damage to the tendons and tendon sheaths, resulting in chronic inflammation and swelling. This is how tendinitis develops. Repetitive tasks, such as flipping a spoon at the wrist or cooking, can cause pain, with the most common being de Quervain's tenosynovitis, which can be confirmed by physical examination. Activities like wringing a towel or cooking can lead to pain. When necessary, treatments such as injections or small needle knife therapy may be required. Rest can relieve most symptoms, but there is a high chance of recurrence. Attention should be paid to wearing wrist braces and applying local heat can help.

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Written by Guan Jing Tao
Orthopedics
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How to reduce swelling from tendon sheath inflammation.

Suggest local physical treatments, often involving electrical therapy and physiotherapy, along with the use of non-steroidal gels applied topically, all of which can effectively reduce local swelling. It is advised to apply for 10-20 minutes per session, two to three times per day, typically improving swelling and pain effectively within one to two weeks. For recurrent, stubborn tenosynovitis, local injection treatments are recommended when necessary, and if there is no significant improvement, local surgical treatment may be considered. (Medication should be used under the guidance of a doctor.)

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Written by Cheng Bin
Orthopedics
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Can tendinitis be treated with hot compresses?

Can hot compresses be used for tenosynovitis? Yes, patients with tenosynovitis can undergo hot compresses. The primary purpose of hot compresses is to promote the absorption of local inflammatory exudates, which can effectively alleviate the symptoms of pain associated with tenosynovitis. Therefore, patients with tenosynovitis can undergo hot compresses. Additionally, it is crucial to strictly ensure rest and protection in the early stages, reducing stimulation to the affected area, which is more beneficial for the improvement of clinical symptoms of tenosynovitis. Topical applications of ointments that invigorate blood circulation and dispel blood stasis can also be used. However, in cases of severe tenosynovitis where there is a snapping sound and the patient's local flexion and extension movements are restricted, it is necessary to actively pursue surgical treatment, which usually involves tenosynovectomy or partial excision surgery.

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Written by Guan Jing Tao
Orthopedics
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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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Written by Lv Yao
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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.