Tendovaginitis is a chronic or acute inflammation of connective tissue membranes surrounding the tendon. Most often this disease develops in the Achilles tendon (Achilles bursitis), ankle, foot, forearm (ulnar and radial tenobursitis), wrist and hand. Tendovaginitis mainly became known due to the defeat of the hands of many famous musicians (the great Shuman, because of the pain in his hand, threw the game on the piano and became a famous composer). Tendovaginitis manifests itself with a crunch during movements, a slight swelling along the affected tendon sheath, painful sensations when moving a group or one muscle
Tendovaginitis - causes
Tendovaginitis can occur as a completely independent disease (primary tendovaginitis), and be secondary because of the complication of any process of a specific or nonspecific character. With purulent inflammation of surrounding tissues, with such common infections as syphilis and tuberculosis , with microtrauma and wounds, the infection penetrates into the tendon sheath and develops an infectious (brucellosis, tuberculosis, nonspecific purulent) tendovaginitis. Also, the development of infectious tendovaginitis may be a consequence of a reaction to the presence of an inflammatory process in some other area (rheumatoid arthritis , rheumatism).
The most widespread was aseptic (noninfectious) tendovaginitis, which develops more often due to excessive loads on the tendon. Associated with a type of professional activity or with a hobby, recurrent cyclical movements lead to microtraumatization, which is the direct cause of the development of tendovaginitis, which is classified as professional. There is also a posttraumatic tenosynovitis, which most often affects professional athletes, although its development can be provoked by ordinary domestic trauma.
Degenerative tendovaginitis is directly associated with various disorders of blood circulation and blood supply to adjacent tissues (varicose veins, etc.). The reason for the development of degenerative tendovaginitis lies in the violation of the blood supply to the surrounding tissues, which leads to degenerative changes in the synovial membrane of the tendon sheath
Tendovaginitis - symptoms
According to the clinical course, tenosynovitis is divided into acute and chronic
Symptoms of acute tendovaginitis
In the case of development of acute tenosynovitis there is a rush of blood and a sharp edema of the synovium, a painful swelling arises in the area of the affected tendon sheaths. With acute tendovaginitis, finger movements are accompanied by a crunch, they are painful and limited. Restriction of movement in the acute form of the disease can manifest itself in the form of persistent finger information (contracture).
Usually, an acute process affects the vaginal tendons of the dorsal surface of the feet and brushes, much less often - the synovial vagina of the fingers of the hand and the flexors of the fingers of the hand. Often, this inflammation is transformed into a chronic form.
When acute infectious tendovaginite swelling and swelling can spread to the lower leg and forearm. In the case of development of purulent inflammation, a chill appears, the body temperature rises, nearby vessels and lymph nodes become inflamed, a purulent or serous fluid appears in the synovial cavity. At the site of the entry of blood vessels into the tendon, due to compression by the inflammatory fluid, its food is disturbed, which may cause further necrosis
Symptoms of chronic tendovaginitis
Typically, chronic tendovaginitis is an occupational disease and primarily affects the hands in the area of the elbow joint and wrist. The main symptoms of chronic tendovaginitis are the following: poor joint mobility, tenderness with active movement, distinct snapping or crunching when the wrist moves or the hand is squeezed. Chronic tendovaginitis most often affects the vagina of tendons of flexor and extensor fingers
Diagnosis of tendovaginitis
The diagnosis of tendovaginitis is established on the basis of clinical studies (palpation of rice bodies, movement disorders, globular painful seals, etc.) and on the characteristic localization of the process. Acute infectious tendovaginitis must be differentiated with acute arthritis and osteomyelitis, in contrast to which, with tendovaginitis on the roentgenogram, there is no change in the joints and bones. There is no joint deformity and pain in the bone region. To exclude stenosing ligament , apply ligamentography. In addition, it is necessary to exclude common diseases that can become a catalyst for the development of tendovaginitis (tuberculosis, brucellosis , etc.)
Tendovaginitis - treatment
заключается в применении местных и общих лечебных процедур. Treatment of acute tendovaginitis consists in the application of local and general medical procedures. With the diagnosed nonspecific acute tendovaginitis treatment is to fight infection by strengthening immune defense and the use of antibacterial drugs. When tuberculous tenosynovitis, the patient is shown the passage of anti-tuberculosis therapy. To treat aseptic tendovaginitis non-steroidal anti-inflammatory drugs (butadione, indomethacin, acetylsalicylic acid) are used. Local treatment of both infectious and aseptic tendovaginitis in the initial stage of development consists in the imposition of warming compresses and gypsum langets. After the subsidence of acute symptoms, the appointment of physiotherapeutic procedures (UHF, ultrasound, microwave therapy, etc.) is shown. Treatment of purulent tendovaginitis consists in the urgent opening and subsequent drainage of the tendon sheath.
помимо всех вышеперечисленных физиотерапевтических методов, включает в себя лечебную физкультуру, массаж, грязевые или парафиновые аппликации, электрофорез с лидазой. Treatment of chronic tendovaginitis, in addition to all the above physiotherapy methods, includes therapeutic exercise, massage, mud or paraffin applications, electrophoresis with lidase. In case of progression of the chronic infectious process, the puncture of the synovial vagina and administration of antibiotics of directed action, the use of non-steroidal anti-inflammatory drugs, the administration of locally hydrocortisone and novocaine are indicated. In the case of persistent crepitating chronic tenovaginitis, the appointment of one or two sessions of X-ray therapy is indicated.
The prognosis, provided the correct timely treatment of tendovaginitis is quite favorable, but with a purulent form, there are often persistent disabilities of the foot / hand
Self-massage with tendovaginitis
Self-massage with tendovaginitis begins on the area lying above the affected area (aspirating self-massage). After three to five strokes, it is necessary to make about three or four strokes and again return to stroking. Repeated stroking manipulations should be tried to draw closer to the painful area. After that comes the turn of four or five squeezing, three or four strokes and five or six kneading. After this, it is necessary to perform three to five strokes of the affected area, followed by a straightforward light rubbing in various directions. Then it is necessary to return to the overlying area, but self-massage is performed already with much greater pressure. In case of pain, rubbing and massage should be stopped.
Self-massage with tendovaginitis is indicated to do two to three times a day. In case the disease affected the hands, during the day they must be further triturated. Self-massage is very well combined with medical and warming ointments, as well as with thermal procedures such as compresses, baths, hot-water bottles, hot baths.
After the thermal procedures and self-massage, you should be very careful not to overcool.