tenosynovit

Tenosynovitis is the inflammation of the synovial sheath that surrounds a tendon, leading to pain, swelling, and restricted movement. It can affect any tendon but is most common in the hand and wrist, especially the tendons of the thumb and fingers. The condition can be acute or chronic and may be noninfectious or septic.

Non-infectious tenosynovitis often results from repetitive motion, overuse, trauma, or inflammatory diseases such as rheumatoid arthritis or gout. Septic tenosynovitis is caused by infection and is a medical emergency, typically resulting from hand injuries or distant bacteremia.

Patients may have tenderness along the tendon, swelling, warmth, stiffness, and pain with movement. In the hand, a triggering sensation or locking may occur in stenosing tenosynovitis (eg, de Quervain's).

Diagnosis is clinical; imaging such as ultrasound or MRI can assess tendon sheath involvement and rule out other conditions. Lab tests may show elevated inflammatory markers; cultures and tests may be needed if infection suspected.

For noninfectious cases, management includes rest, immobilization, NSAIDs, physical therapy, and possibly corticosteroid injections into the tendon sheath. For septic tenosynovitis, prompt antibiotic therapy and surgical drainage are needed. Refractory or stenosing tenosynovitis may require surgery to release the sheath or partial tenosynovectomy.

Most patients recover with appropriate therapy, though chronic cases may persist. Preventive measures include avoiding repetitive strain, ergonomic adjustments, and gradual return to activity; early treatment improves outcomes.