Sunday, May 29, 2011

Tenosynovitis - Treatment

Prompt medical therapy of acute suppurative tenosinovitelor can remove the need for surgery. To apply ice tenosinovitele by wear and tear, they raise the affected limb, and anti-inflammatory corticosteroid is administered.If a patient presents early with such a condition is given intravenous antibiotics. Empirical antibiotics include cefazolin, clindamycin or erythromycin. Immunocompromised persons requiring cefotaxime sulbactam administration. Conservative therapy includes splitting the wound, increasing the area affected special exercises to mobilize and control swelling.
Inflammatory therapy in rheumatoid tenosynovitis.This includes local application of ice, administration of NSAIDs, rest, cutting local hidroxicloroquina, gold salts, penicillamine and methotrexate. Existing cases require oral steroid treatment.Corticosteroid therapy for acute episodes without improvement.Injections are limited to not cause tendon rupture.
Tenosinovitelor therapy caused by wear and tear.Indicate reduced activity, apply ice and raise the affected area.NSAIDs are administered if the patient tolerates them. We recommend a short course of steroids. Sheath steroid injections in preventing reinitiation of inflammation. Rehabilitation reinflamatia prevents slow. Corticosteroids are used especially in diabetes and rheumatoid arthritis.
Therapy in the Quervain tenosynovitis.Enter the rest, NSAIDs and split thumb. We recommend lidocaine and corticosteroid injections. Surgery is an option if that fails conservative.
Gonococcal tenosynovitis.It into the hospital and administered intravenous ceftriaxone or spectinomycin. Surgical drainage and antibiotic therapy is indicated if the condition does not improve significantly within 48 hours.
Therapy in infectious tenosinovitele nongonococice.It indicates raising the affected limb and administering antibiotics to cover streptococci or staphylococci. Add anaerobic spectrum if such infection is suspected.Hospitalization is required for tenosinovitele gonorrhea and other infectious tenosynovitis. Repeated joint aspiration may be needed in septic arthritis associated with infectious tenosinovitele.
Prognosis.Urmatoarii adverse prognosis is associated with factors: age over 50 years, presence of diabetes, kidney failure, peripheral vascular disease, ischemic changes at the time of presentation, purulent subcutaneous and polymicrobial infections.A tendosinovitei infectious complication is loss of joint movement.A less common complication of infectious tenosinovitelor is finger amputation, which occurs in advanced cases. Tenosinovitelor Complications may include chronic pain, chronic disability, limiting movement of the affected area, amputation of fingers.Tenosinovitele have a good prognosis with antibiotic therapy and the infectious corticosteroid therapy or those noninfectioase conservative. evolution towards the destruction of the bone tendon or dissemination of infection are possible complications.

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