Tendon inflammation

Inflammation of the tendons is a symptom complex that develops due to their pathology, which is accompanied by pain and impaired movement in the segment.

Tendovaginitis is the predominant type - inflammation of the tendons, namely the synovial sheath. Tendovaginitis should be distinguished from peritendinitis, when the pathological process is localized in the sheaths, paratendinitis - inflammation of the tendons and the loose tissue surrounding them, localized outside the synovial sheath on the forearm, shin, in the Achilles area, although they are often combined, as they are inflammatory periprocesses, as well as ligamentitis.

According to etiology, tendon inflammation is divided into: infectious, caused by pyogenic microflora that enters the synovial sheath through wounds or through penetration from adjacent foci of infection; infectious-allergic, developing as reactive inflammation of the tendons in systemic diseases; aseptic (acute crepitant and chronic stenosing tendovaginitis), occurring with microtrauma and overexertion, usually in people of certain professions who perform monotonous movements (musicians, typists, etc.), and athletes, especially often in speed skaters and skiers.

Acute infectious inflammation of the tendons often develops when an abscess or wound is localized with an opening of the synovial sheath on the palmar surface of the hand or the plantar surface of the foot. The process is accompanied by sharp pain, swelling, hyperemia, dysfunction of the hand or foot with rapid spread of the process to the forearm or lower leg. The need for urgent opening of the synovial sheath to prevent necrosis requires immediate hospitalization in a surgical hospital.

Infectious-allergic inflammation of tendons develops during exacerbation of a chronic systemic disease, such as rheumatism, is combined with polyarthritis and polymyositis and is covered by them in clinical manifestations, is revealed by pain during palpation of muscles. For treatment, the patient is referred to a rheumatologist.

Acute crepitant tendovaginitis is more often observed when there is inflammation of the tendons of the hand, foot, and biceps. There is pain, limited mobility, swelling; the area of the pathological process is painful upon palpation, passive movements are painful, and a characteristic crunch is detected during them. Athletes may experience Albert's syndrome - pain during exertion and painful inflammation of the tendons in the area of the calcaneal tuberosity and the attachment site of the Achilles tendon. Conservative treatment by a surgeon.

Ligamentitis ("trigger finger") is a reactive inflammation of the tendons of the annular ligament of the sheath at the level of the base of the proximal phalanx of the fingers, which leads to their compaction and narrowing of the ligament ring. It occurs as a result of functional overexertion, injury, as a result of panaritium. Movements inside the annular ligament are difficult, a "snapping" symptom occurs, when the finger is fixed in a flexed position and the patient feels an obstacle when extending it. Mostly, the 1st, 3rd, and 4th fingers are affected. The signs are swelling and pain in the area of the thickened ligament, difficulty in flexing and extending the finger.

There are 3 stages of disease development:

1. difficulty moving the finger, mainly in the morning;
2. development of the symptom of “snapping” of the finger, the extension of which is accompanied by sharp pain and a characteristic click;
3. development of flexion contracture, when finger movements are impossible. In the first stage, treatment is conservative, in the second and third stages, surgical in the hand microsurgery department.

A ganglion is a cystic formation in the perisynovial tissue of the joint capsule.

It is a fibrous unicameral or multicameral cyst filled with a gelatinous substance rich in mucin. It is mainly localized on the back of the hand and wrist joint between the extensors, and can rarely be found in the area of the knee joint, ankles, or on the back of the foot. It appears as a clearly contoured, dense, rounded formation from 3 cm to 5-6 cm in diameter. The skin is not fused with it or changed. If the ganglion bothers as a cosmetic defect, is small in size, and is localized on the back of the hand or foot, the crushing technique can be used (several blows with a medium-strength wooden hammer), in all other cases, surgical treatment.

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