Tendovaginitis (ICD-10 code M65) is a disease characterized by inflammation of the tendons and surrounding sheaths. Tenosynovitis can only develop in a tendon that has a soft tunnel, represented by connective tissue. There are many reasons for the development of this disease - these are infections, rheumatic pathologies along with professional sports and not only. So, let's start our article with the symptoms that accompany this pathology.
Treatment of tendovaginitis will be discussed later.
Symptomatics
Symptoms of tendovaginitis, regardless of the location of the inflammation, have a similar picture. The following signs indicate the presence of an acute form of inflammation:
- The presence of pain, localized in the place where inflammation occurs. The pain is acute and does not depend on the time of day. In the event that pus accumulates in the synovial bags, the patient feels a pulsation. Pain canintensify when a person attempts to move with the involvement of inflamed tendons in this process.
- Appearance of puffiness with tendon tendonitis. In the area of inflammation, the vessels usually expand, becoming permeable, and the fluid from them leaks out. It can linger in the tissues, which leads to the formation of edema, which is of considerable size. Sometimes, due to edema, cracks form on the skin surface. Edema grows very quickly, as fluid is constantly produced by the synovial walls. It happens that tendovaginitis, which manifests itself in the area of the fingers, after a couple of hours leads to swelling of the entire limb. This is how tendovaginitis of the wrist joint often manifests itself.
- Development of hyperemia of the skin. Redness of the dermis occurs due to excessive filling of small vessels with blood. First, the redness spreads over the skin and takes the form of the tendon that has been inflamed. Further, the area of hyperemia is more extensive. In the event that you touch the area with the most intense color, you can hear a slight crunch.
- Local increase in temperature in tendovaginitis of the ankle joint. This symptom can also be explained by increased blood flow to the area of inflammation.
- Appearance of disorders in the work of the limb. In the event that the inflammation is localized in the area of the flexor tendons, then the leg or arm will simply be impossible to bend. If the extensors are involved in the pathological processes, there will be severe pain during extension. There will be little pain when the tendon is at rest.
Any pathological formations lead to limitation of tendon mobility. Against this background, the limb may completely or partially lose its ability to function.
Types of tendovaginitis
To systematize information, doctors use several classifications of tendovaginitis, which are based on different criteria. So, depending on the nature of the inflammation, the following types are distinguished:
- Development of serous tendovaginitis. This is the initial form of the disease. Against its background, the patient has a minimal set of symptoms in the form of slight redness against the background of inflammation, along with a slight swelling of the tissues.
- Development of serous-fibrous tendovaginitis of the ankle joint. At the same time, effusion accumulates in the synovial vagina, and, in addition, swelling is formed, and pain increases.
- The occurrence of purulent tendovaginitis. Against its background, redness intensifies, and the pain becomes so unbearable that a person needs emergency therapy.
Acute and chronic tendovaginitis
Depending on how the disease proceeds, acute tendovaginitis and chronic are isolated. And depending on the etiological factors that caused the development of the disease, they distinguish:
- Aseptic type of tendovaginitis, which is divided into professional, reactive and post-traumatic.
- Infectious type of tendovaginitis, which may benon-specific or specific.
What is crepitating tendovaginitis?
The cause of the problem also makes it possible to differentiate the disease. It can be:
- infectious (non-specific, specific);
- aseptic (crepitating, stenosing).
If the word “aseptic” is present in the name of the disease, this means that the synovial membrane of the tendon has become inflamed not due to any infectious disease of the body or infection from the outside, that is, a wound, cut, puncture.
There is a big difference between aseptic crepitating tendovaginitis and infectious tendovaginitis. The first can be recognized by the characteristic crackling that is heard during palpation of the swollen area or during movement of the limb, when the tendon moves along the injured synovium.
Tendovaginitis and its diagnosis
It is very important that the diagnosis of tendovaginitis is not only of high quality, but also fast. The success of treatment directly depends on this, and, in addition, the likelihood of certain complications.
Usually, doctors do not experience any difficulties in making a diagnosis. For this, an external examination of the patient is enough to suspect tendovaginitis of the wrist joint. Specialists, as a rule, start from the signs of the disease described above. The patient may experience swelling along with contracture and deformity of the tendon capsule. Against the background of septic inflammationthe patient may suffer from general intoxication of the body. The temperature at the same time exceeds 38 degrees, and, in addition, there is increased sweating along with chills.
Chronic tendovaginitis is more difficult to diagnose, since the symptoms of the disease are not pronounced enough, and directly during the period of remission, it can be completely absent. Therefore, patients who have had acute tendovaginitis once, it is necessary to pay attention to their he alth. Usually, chronic tendovaginitis is confirmed with repeated inflammation of the synovial bags. As part of the confirmation of the diagnosis, the following methods are used along with laboratory tests:
- Performing blood sampling for general analysis. With severe inflammation, an increase in ESR with leukocytosis is observed.
- Bacterioscopic analysis of purulent contents of tendon synovial bursae. To do this, perform a puncture.
- If sepsis is suspected, blood is tested for sterility.
- Performing computed tomography allows you to visualize the thickening of the soft tissue, and, in addition, to see the presence of adhesions.
Carrying out an X-ray examination in terms of detecting tendovaginitis is uninformative. So, then we will find out how tendovaginitis is treated.
Performing therapy
Treatment is usually medical or surgical. Physiotherapeutic procedures that are allowed to be practiced even against the background of the acute stage of tendovaginitis have a good effect. The doctor should assess the patient's condition and establish how intense the inflammation is.
Treatment of acute and chronic aseptic tendovaginitis
Acute, and, in addition, chronic aseptic tendovaginitis can be cured exclusively through the use of drugs. In this case, the patient is prescribed anti-inflammatory drugs used not only locally, but also systemically. Antibiotics are prescribed by the doctor at his own discretion. Most experts believe that they can even be used prophylactically in order to prevent suppuration of synovial bags and tendon tissue. What are the recommendations for the treatment of tendovaginitis?
Patients with acute septic tendovaginitis are advised to minimize stress on the affected limbs. For this, gypsum is used. Cold is applied to the affected area. Analgesics are used to reduce pain in tendovaginitis of the tendon. In the event that the therapy was carried out adequately, it is possible to completely get rid of the disease in just a few days.
To avoid recurrence, it is recommended to minimize the load on the limb in the future. Especially if it's tendovaginitis of the forearm. Shock wave treatment is one of the effective methods of treatment of aseptic tendovaginitis. Among the physiotherapeutic methods, phonophoresis with hydrocortisone is also used, and, in addition, electrophoresis with potassium iodide and novocaine is used.
In the event that with the help of analgesics or physiotherapy procedures it is not possibleto stop the pain, then the patient is recommended to set up a therapeutic blockade with the use of hormonal drugs. As soon as the acute stage of the disease is completely eliminated, the patient will be prescribed a special gymnastic complex.
In order to prevent exacerbations of the disease, a patient with chronic tendovaginitis is prescribed "Ozokerite". If the treatment does not bring the desired effect, then in this case the affected tendon sheaths are excised or dissected. What exactly should be done in this or that case, the doctor decides.
Treatment of acute form of post-traumatic tendovaginitis
For the treatment of acute tendovaginitis, a plaster or plastic splint is applied to the damaged area. In the first days after the injury, cold must be applied to the sore spot, and then thermal procedures are recommended. UHF therapy has a good effect.
If the disease was diagnosed at an early stage, then until the abscess forms, conservative treatment is allowed. For these purposes, the limb is immobilized, the patient is injected with novocaine blockade, applying alcohol lotions. Of the physiotherapeutic methods, the use of UHF treatment and laser therapy is shown.
In the event that an accumulation of pus occurs in the area of synovial bags, then an operation is indicated. At the same time, the synovial vagina is widely opened, and it is relieved of purulent masses by washing with antiseptic solutions. Immediately before the operation and after it is performed, the patient must undergoantibiotic therapy.
Medication treatment
Medicines used to treat tendovaginitis (ICD-10 code M65) are typically:
- Treatment with drugs from the group of non-steroidal anti-inflammatory drugs in the form of Nimesulide and Diclofenac.
- Therapy with glucocorticosteroids, such as Dexamethasone. Hands are often prescribed for tendovaginitis.
- The use of antibiotics. In this case, the drug "Ceftriaxone" is mainly used.
Treatment with physiotherapy techniques
Physiotherapy methods that are used to treat tendovaginitis of the hand are usually as follows:
- Electrophoresis treatment.
- Therapy by applying alcohol compresses.
- Laser therapy.
- Performing UHF therapy.
- Ultrasound treatment.
- Treatment with mud and massage.
At the stage of remission of the disease, the patient must necessarily engage in therapeutic exercises. The load on the tendons should increase gradually. Now we will find out which of the folk recipes are used to treat this disease.
Folk treatment of tendovaginitis
There are situations in which the question arises as to how to cure a pathology without drugs. In the presence of drug intolerance or an allergic reaction to antibacterial drugs, they turn to useful plants. Traditional medicine for tendovaginitis is recommendedtreatment with herbal infusions, decoctions, compresses and ointments. Here are some recipes:
- Treatment of tendovaginitis with calendula ointment. To prepare the medicine, take an equal amount of calendula flowers and baby cream, after which everything is mixed. The ointment is applied to the affected surface. The affected area is covered with a bandage, leaving it overnight. This recipe is antimicrobial and anti-inflammatory.
- Treatment of tendovaginitis with wormwood. They take two tablespoons of dry wormwood, add 200 milliliters of boiling water and infuse the medicine for half an hour. Then the tincture is filtered and drunk on a spoon before meals three times during the day. This medicine can have an anti-inflammatory effect, and, in addition, a restorative effect.
- Treatment of tendovaginitis of the fingers with shepherd's purse compresses. The infusion is prepared as follows: a spoonful of grass is poured with 200 milliliters of boiling water. Next, the product is infused in a thermos for two hours. A water bath will also work. Then the medicine is filtered and applied as part of local treatment in the form of compresses at night.
- Treatment of tendovaginitis with pork fat and wormwood ointment. Take 100 grams of lard and 30 grams of wormwood. All ingredients are boiled over low heat, cooled and applied to the sore spot.
- Compresses using medical or bear bile. Bile is heated in a water bath and with its help a regular compress is made, which is applied to the patient.place. Keep the medicine for one night. Bile can have a resolving, and at the same time, anti-inflammatory effect. Treatment with such compresses gives good results.
Which doctor treats tendovaginitis? In the event that a person suffers from such a disease, then he should turn to highly specialized specialists, which are a rheumatologist, orthopedist and arthrologist.
