Tenosynovitis causes the trochlear groove, i.e. the tendon sheath in which the muscle tendons slide, to become inflamed. Tenosynovitis can principally affect every tendon. Tendon sheath inflammation is observed most frequently on the wrist and foot.
In the majority of cases, long-term and chronic overuse of the tendon is responsible for the occurrence of tenosynovitis. For example, during sports such as jogging, cross-country skiing or tennis. However, also constant stress on the wrist through repetitive actions (computer workplace, musicians) can cause tenosynovitis. However, tenosynovitis on the wrist should not be confused with carpal tunnel syndrome, which causes a pinched nerve.
Besides chronic overuse, tenosynovitis can occur in rarer cases after an bacterial infection (e.g. after a stab wound) or through rheumatic illnesses.
The main symptom of tenosynovitis is a stabbing pain along the length of the tendon and the muscle. The pain increases when pressure is placed on the tendons and when moving the muscle. If the tenosynovitis is severe, the patient will also be in pain when their wrist is at rest. There is often redness and overheating along the inflamed tendon. The chronic form of tenosynovitis can cause nodule-like thickening of the tendons. Sometimes the phenomenon known as “trigger finger” can be seen in such cases. The thickened tendon initially remains in the tendon sheath and suddenly detaches when muscular contraction becomes stronger. The affected finger suddenly snaps forwards when it is stretched out.
The diagnosis of tenosynovitis is made on the basis of the symptoms and an examination of the affected tendon. However, a blood test is carried out to detect bacterial infection or to rule out rheumatic disease.
Tenosynovitis is usually treated conservatively. The earlier the treatment is started, the more likely the illness can be treated without surgery. It is important to remove any pressure on the affected tendons and muscles so that the inflammation can subside. Depending on the extent of the symptoms, this process is supported with painkillers or anti-inflammatory medication. Electrostimulation or shock wave therapy are sometimes used.
Surgical treatment with splitting of the tendon sheath remains is only used in chronic cases in which conservative treatment does not produce the desired results.
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