Tenosynovitis

Tenosinovitele imply its sheath and tendon inflammation.Examples of tenosynovitis include: Quervain tenosynovitis of the hand wrist (abductor tendons of the thumb and long thumb extensor low, tenosynovitis flexors, tenosynovitis of the flexors piogenica. Flexors tendons in his hand slip fibrocartilaginoase tunnels. Visceral and parietal layers of synovium lubricate and nourish the tendons . These layers are usually empty when infection that follows the path of lesser resistance along the tendon sheath or inflammation are not present.Infection can be introduced directly into the tendon sheath of skin through a wound or by extension most commonly in marrow and gonococcal tenosynovitis. Gonococcal infection originates from infected genital tract mucosa, rectum, or pharynx. Dissemination occurs in 3% of patients with mucosal infection. Approximately two thirds of patients with disseminated gonococcal infection develop tenosynovitis.
A history of recent trauma is frequently affected area is a predisposing factor for development of tenosinovitei piogenice flexors. Suprauzajul leads to inflammation and the Quervain tenosynovitis.A tendosinovitei infectious complication is loss of joint movement.A less common complication of infectious tenosinovitelor is finger amputation, which occurs in advanced cases. 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.
Prompt medical therapy of acute suppurative tenosinovitelor can remove the need for surgery. 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. To apply ice tenosinovitele by wear and tear, they raise the affected limb, and anti-inflammatory corticosteroid is administered.Hospitalization is required for tenosinovitele gonorrhea and other infectious tenosynovitis. Repeated joint aspiration may be needed in septic arthritis associated with infectious tenosinovitele.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. Destruction of the bone tendon or dissemination of infection are possible complications.
Tenosynovitis - Signs and symptomsPatients with infectious tenosynovitis of the flexors is present at a time after a penetrating injury with pain, redness, fever. Physical examination showed signs of infection Kanaval sheath flexors.These signs may be absent in patients who received antibiotics recently, in early manifestations of the condition, chronic infections, immunocompromised. In addition, immunocompromised patients may be penetrating wounds and foreign bodies. Clinical symptoms are vague in some indolent infection.Rheumatoid tenosynovitisPatients with rheumatoid tenosynovitis and tendon rupture may be.Passing tendon rupture occurs when the surface was rough or eroded by chronic synovitis. The tendon can be weakened by arthritis tenosinovitei direct invasion or necrosis of surrounding tissue ischemia and impaired blood intake.Quervain tenosynovitis ofPatients have a history of restriction of movements of the thumb and fingers. Pain is radial wrists. It worsens with activity and improves with rest. Pain is typically gradual onset with no history of acute trauma. Most affected are middle-aged women. Appears to palpation palpation over inchieturii.Tenosynovitis flexors his handSensitivity is present at the proximal end of the tendon sheath in the distal palm. Is this nodularitatii and thickening of tendon palpation. Tendon crepitus can be appreciated when the finger flexes. This type of tenosynovitis affects especially the thumb and ring finger. Occurs mainly in middle-aged women with diabetes.Thumb flexion is followed by a quick release, so it denotes the finger shooter, radiating pain in the fingers. In more severe cases require finger manipulation to regain passive extension.Gonococcal tenosynovitisThis type of inflammation affecting mostly young people and young adults is more common in women, especially during pregnancy or after menstruation, when dissemination occurs gonorrhea. The interval from onset of intercourse and dissemination variz from day to several weeks. Vaginal or penile Debaclurile absent, fever, malaise, chills and poliartralgiile are common. Areas affected are the back of the hand wrist and ankle. Are erythema, tenderness to palpation and painful movement. Fever is common. Dermatitis is also common, occur at a third of people, characterized by hemorrhagic macules or papules on the distal extremities of the trunk.Infectious tenosynovitis nongonococicaYou might have a plate puncture, laceration, skin tears, biting or pressure injection injuries. Often not present any gate. Pain and swelling occur along the affected tendon. Miiinii flexor tendon is the most involved. The apparent sensitivity, redness and painful movements of the affected tendon.Kanavel's cardinal signs include:Fusiform swelling of the finger-Flexed position of the thumb--Severe pain with passive finger extension-Sensitivity and swelling along the flexors and limited to the sheath.
Tenosynovitis - ComplicationsTenosinovitelor 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. Destruction of the bone tendon or dissemination of infection are possible complications.A tendosinovitei infectious complication is loss of joint movement.A less common complication of infectious tenosinovitelor is finger amputation, which occurs in advanced cases. 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.