Tendinitis and tendinopathy

Tendinitis is an inflammatory condition characterized by pain at tendinous insertions on bone. The term tendinosis refers to tendon degeneration observed histopathologically. Tendinopathy is a generic term and describes a common clinical condition affecting the tendons, cause pain, swelling or impaired physical performance. Because the disease tendon pain is not the nature of tendinopathy is an inflammatory term than current trends.Common site of tendinitis include: capacity bicipitale cuff tendons and shoulder, wrist extensors and flexors insert elbow, patellar tendon and the popliteal, posterior tibial tendon insertion, the Achilles tendon at the heel.
Tendons transmit force to the skeleton muscles. Thus they are subject to repeated mechanical loading, a major causative factor in the development tendinopatiei. Histological elements include tendon inflammation, mucoid degeneration and fibrinoid necrosis of the tendon. Tendinitis exact pathogenesis is not yet clear. Leads to the weakening of chronic tendinopathy and tendon rupture.Triggers include usajul tendinitis, strenuous exercise, repeated and sustained, sustained extreme positions, insufficient recovery after physical activity, vibration and cold temperatures. Tendinitis develops in some patients after several days to 6 months after completion of a course of therapy with quinolones. Pathological mechanisms are multifactorial tendinopatiei after fluoroquinolone.Studies show changes in ischemic, toxic and degenerative.
Exercise is important in the prevention and treatment tendinopatiei. Toning exercises show efficacy. Shock wave therapy which stimulates tenocitele to repair can be effective.These growth factors are used for several years to improve treatment cure tendinitis. Nitric oxide applied by topical nitroglycerin is an option. Sclerosing injections shows improvement in the short term. Gene therapy promises the introduction of anabolic factors and antianabolici. Have been developed and reconstruction techniques to replace or repair damaged tendons. Patients with symptoms resistant to conservative therapy often require arthroscopy or surgical treatment for decompression and tendon tenodezis.The patient's evolution is generally good with rest and conservative therapy.
Tendinitis - classification and clinical manifestationsCommon site of tendinitis include: capacity bicipitale cuff tendons and shoulder, wrist extensors and flexors insert elbow, patellar tendon and the popliteal, posterior tibial tendon insertion, the Achilles tendon at the heel. Tendons are subject to repeated mechanical loading, a major causative factor in the development tendinopatiei.Middle-aged adults are most often affected.
Lateral and medial epicondylitis.Pain on the sides of the elbow is the characteristic mark and gets worse with supinatie. The patient may present a history of tennis practice or manual labor. Medial epicondylitis is associated with golf, the coavoare tasutul, bowling. The pain is on the medial elbow.
Cape cuff tendinopathy.It is associated with activities such as painting, fins. Typical symptoms are painful cramping in shoulder movement. Pain on palpation of the great tuberosity occurs where muscles insert. Jobe test for supraspinalilor function: both arms are up to 90 degrees, to keep in front of the body and the arms in pronation resistance is applied to compare this pain. Failure to maintain arms or the onset of pain is suggestive cape cuff tendinitis.
Bicipitala tendinopathy.Pain in the shoulder before the pit bicipitala. It is worse with shoulder flexion or supinatie arm. Sensitivity is present in the trench between the humeral greater tuberosity and small. Biceps resistance test result supinatie wrist pain or elbow flexion at 90 degrees and the arm brought to the body.
Patellar tendinopathy.Sensitivity in the inferior pole patellar insertion. It is associated with insidious onset of pain well localized in previous knee. Patellar tendinitis is common to those who practice baschetball, volleyball and runners. Pain is worse with position change from sitting to standing, to walk or climb.
Popliteusului tendinopathy.This type of tendinopathy associated with lateral knee pain.Coboritul to run a hill is a trigger. Sensitivity is located on the posterior lateral joint line. With the patient in supinatie the knee flexed to 90 degrees and internally rotated leg, external rotation cause pain.
Iliotibiale band syndrome.The pain is located on the lateral femoral condyle. With the patient in supinatie and knee flexed to 90 degrees will expand patient knee lateral femoral condyle put pressure on. Pain at 30 degrees flexion is suggestive Renn-test positive. Ober test: the patient is lying on the unaffected and unaffected hip and knee to 90 degrees.If the band is affected iliotibiala patient experiences pain in the foot over the line bringing the median. The condition is common in knee wear and tear. It is observed in cyclists, dancers, long-distance runners, football players and soldiers. Typically after the pain starts running or jogging a few minutes after starting. Hill Descent is aggravated by sitting position with knees flexed or extended.
Achilles tendinopathy.Sensitivity is located at 6 cm proximal to tendon insertion on the heel. Pain from plantar flexion and heel dorsiflexia. Runners and other athletes have a higher incidence of Achilles tendinitis.Surface Modification and running shoes were associated bad.
Calcified tendonitis.It is a morphological condition. It may be discovered accidentally and do not cause symptoms. Affects especially the shoulder and is characterized by macroscopic deposits of hydroxyapatite in either cape cuff tendons.It may present as:Mild-chronic pain and episodes of worsening intermittent incarceration similar shoulder syndrome is thought to indicate the training phase of the pathology-Mechanical symptoms may occur through increased calcium storage block lifting shoulder-Severe acute pain is attributed to the resorption phase of the inflammatory response.Stages of evolution of calcified tendinitis:Formative phase. As a result of an unknown trigger susceptibility to a portion of the tendon tissue calcification appears fibrocartilaginoasa and transformed. The deposit will be similar to larger scale.Resting phase. Once formed, limestone deposit rapaus enters phase. Deposits may or may not be painful. If they are large enough determjina mechanical symptoms.Resorption phase. After a variable is an inflammatory reaction.Vascular tissue grows at the periphery of the deposit.Macrophages and giant cells absorb deposits in this phase.Deposits are like toothpaste and occasionally escaping in stock subacromiala painful symptoms.Postcalcifianta phase. Once absorbed deposits were reconstituted collagen tendon fibroblasts.