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Tenosynovitis
Definition:
Inflammation of the lining of the sheath that surrounds a tendon, the cord that joins muscle to bone.
Alternative Names:
Synovitis
Causes, incidence, and risk factors:

The synovium is a lining of the protective sheath that covers tendons. The condition of tenosynovitis is defined by inflammation of the tendon and the sheath. The cause of the inflammation may be unknown, or it may result from injury, overuse, strain, or infection. The wrists, hands, and shoulder are areas that may be affected, although it may occur at any tendon site. When the wrist is affected, it may cause carpal tunnel syndrome.
Symptoms:
  • Difficulty moving a joint
  • Pain and tenderness around a joint, especially the hand, wrist, foot and ankle
  • Pain on movement of a joint
  • Joint swelling in the affected area


Signs and tests:

A physical examination shows swelling over the involved tendon and pain when the tendon is touched, stretched, or the muscle to which the tendon is attached is used.
Treatment:

The goal of treatment is to relieve pain and reduce inflammation.

Rest or immobilization of the affected tendons is essential for recovery. Splinting, or a removable brace may achieve this. The application of heat or cold to the affected area will reduce the pain and inflammation. Non-steroidal anti-inflammatory medications (NSAIDs) relieve pain in addition to reducing inflammation. Local injections of corticosteroids may be useful. Rarely, surgical release of the tendon is required.

If the condition is caused by infection, antibiotics will be prescribed. In some cases, an operation to release the pus around the tendon may be indicated.

After recovery, strengthening exercises involving the muscles surrounding the affected tendon may prevent recurrence of the injury.
Expectations (prognosis):

The probable outcome is full recovery with treatment, but recurrences may happen if the condition is caused by overuse, and the offending activity is not stopped. In chronic conditions, the tendon may be damaged and recovery may be delayed or incomplete.
Complications:

If untreated, permanent restriction of the tendon or tendon rupture may result.
Calling your health care provider:

Call for an appointment with your health care provider if there is pain or difficulty straightening a joint or extremity.
Prevention:
  • Avoid repetitive movements and overuse of an extremity
Review Date: 5/30/2001
Reviewed By: Benjamin D. Roye, M.D., M.P.H., Department of Orthopaedics, New York-Presbyterian Hospital, New York, NY. Review provided by VeriMed Healthcare Network.

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