Tendovaginitis is an inflammation of the inner lining of the fibrous vagina of the muscle tendon( synovial membrane).This synovial membrane facilitates the sliding of the corresponding tendon in the osteo-fibrous canals when performing work in the muscles and joints.
People are interested in the treatment of tendovaginitis:
- wrist joint,
- forearm and so on.
But, in fact, the pathological process is localized precisely in the internal synovial membrane of the muscle tendon.
IBD code 10 correlates tenosynovitis:
- to lesions of synovial membranes and tendons - code M65-M68,
- synovitis and tenosynovitis - code M65,
- other synovitis and tenosynovitis - code M65.8.
Tendovaginitis is acute and chronic.
Acute tenosynovitis is manifested by edema of the synovial membrane and accumulation of fluid in the cavity of the synovial membrane.
Chronic tenosynovitis is accompanied by thickening of the synovium and accumulation in the synovial cavity of effusions with high fibrin content. Over time, as a result of the organization of fibrinous effusion, the so-called "rice bodies" are formed, and the lumen of the tendon sheath decreases.
Depending on the nature of the inflammatory process, there are serous, serous-fibrinous, and purulent tenosynovitis.
Today we will consider the treatment of tendovaginitis of the wrist joint, hand, foot, tendon, finger, ankle, forearm at home with official medications, medicines, procedures and folk remedies.
Tendovaginitis: species, examples, symptoms
May be acute and chronic, serous or purulent.
An example of an infectious tendovaginitis can serve as a tendon of panaritium( tenosynovitis of finger ).With it, the patient's finger is evenly enlarged, slightly bent and painful. Pressure over the tendon sheath and attempt to cause passive movements are accompanied by a sharp pain.
The vagina is infected all over for several hours. The general condition of the patient is severe due to intoxication.
Aseptic inflammation of the tendon sheath or( which is more common) of the tissue surrounding the tendon. Developing creping tendovaginitis on the limbs( more often the upper - forearm, wrist joint ) mainly in connection with physical work, as a professional disease( milkmaids, laundresses, volleyball players) or, conversely, when doing prolonged unaccustomed physical work.
Aseptic inflammation of the ring-shaped ligament of the finger( " springing finger ", " snapping finger ") or the rear of the wrist ligament .In the etiology of the appearance of this species, acute or chronic trauma is of great importance. More often the disease develops in women 30-50 years old.
Tendovaginitis: the causes of
Depending on the causes of the disease can be identified such groups of tendovaginitis:
The first group of : Independent aseptic tendovaginitis, the occurrence of which is a consequence of prolonged microtraction and overstrain of synovial sheaths of tendons and adjacent tissues in individuals of certain professions( carpenters,locksmiths, loaders, typists, pianists, stockists, brickmakers, workers in the heavy metallurgical industry), inLong-lasting movements of the same type, in which a limited group of muscles participates;In addition, such tendovaginitis can appear in athletes( skiers, skaters and others) in overtraining.
Second group : Infectious tendovaginitis:
- specific tenosynovitis in some infectious diseases( such as gonorrhea, brucellosis, tuberculosis, etc.), in which the spread of pathogens is more often hematogenous( with blood flow);
- nonspecific tendovaginitis in purulent processes( purulent arthritis, panaritium, osteomyelitis), from which the inflammation spreads directly to the synovial vagina, as well as with injuries;
The third group of : Reactive tendovaginitis, the appearance of which accompanies rheumatic diseases( rheumatism, Bekhterev's disease, rheumatoid arthritis, systemic scleroderma, Reiter's syndrome and others).
Tendovaginitis: manifestations and symptoms
For acute non-specific tenosynovitis is characterized by an acute onset and rapid development of painful swelling at the site of the affected synovial sheaths of the tendon sheaths.
Most often, acute tendovaginitis occurs in the tendon sheaths on the back surface of the feet and hands, more rarely in the synovial vagina of the fingers and in the vagina of the flexor tendons of the fingers.
Swelling and tenderness, as a rule, spread from the foot to the lower leg and from the hand to the forearm. There is a restriction of movement, it is possible to develop flexion contracture of the fingers.
If the inflammatory process becomes purulent, body temperature rises quickly, chills appear, regional lymphadenitis develops( enlarged lymph nodes due to inflammation) and lymphangitis( inflammation of the lymphatic vessels).
Purulent tendovaginitis develops more often in the area of the vagina of the tendons of the flexor flexors.
For acute asseptic tendonitis of is characterized by the defeat of the synovial vagina on the dorsum of the hand, not so often - the feet, even less often - the intercampis synovial vagina of the biceps( biceps muscle of the shoulder).
The onset of the disease is acute: a swelling is formed in the area of the affected tendon, when probed, there is a crepitation( crunching).There is a restriction of the movement of the finger or tenderness when moving. A transition to a chronic form of the disease is possible.
For chronic tendovaginitis is characterized by the defeat of the vaginal tendons of the flexor and extensor fingers in the area of their retainers. Often there are symptoms of chronic tendovaginitis of the common synovial vagina of the flexor of the fingers - the so-called carpal tunnel syndrome, in which a tumor-shaped, painful elongated shape is formed in the region of the wrist canal, having an elastic consistency and often taking the shape of an hourglass that moves slightly during movement. Sometimes you can feel the "rice bodies" or determine the fluctuation( sensation of the transfer wave, caused by the accumulation of fluid).Characteristic limitation of tendon movements.
A distinctive form of is the , the so-called stenosing tenosynovitis , or tenosynovitis de Kervena , which is characterized by a lesion of the vagina of the tendon of the short extensor and the long branching muscle of the thumb of the hand.
The walls of the vagina with this form of tendovaginitis thicken, and the cavity of the synovial vagina, respectively, tapers.
Tendovaginitis de Kervena is manifested by pain in the location of the styloid process of the radius, which often radiates to the first finger of the hand or to the elbow, as well as swelling. The pain intensifies if the patient presses the first finger to the palmar surface and bends the rest of the fingers over it;if at the same time the patient takes the wrist to the elbow, the pain is abrupt. In the course of the vagina palpation, an extremely painful swelling is determined.
The tubercular tenosynovitis of is characterized by the formation of dense formations( "rice bodies") along the extensions of the tendon sheaths, which can be palpated( palpated).
Purulent radial tenobursitis - is usually a complication of purulent tenosynovitis of the thumb .It develops if the purulent inflammation spreads to the entire vagina of the tendon of the long flexor of the thumb of the hand. Characterized by severe soreness along the palmar surface of the thumb of the hand and further along the outer edge of the hand to the forearm. If the disease progresses, the purulent process can spread on the forearm. Purulent ulnar tenobursitis - is, as a rule, a complication of purulent tenosynovitis of the little finger of the brush .Because of the peculiarities of the anatomical structure, the inflammatory process quite often passes from the synovial vagina of the little finger to the common synovial vagina of the flexor of the hand, less often to the synovial vagina of the tendon of the long flexor of the thumb. In this case, the so-called cross phlegmon develops, which is characterized by a severe course and is often complicated by a disruption in the functioning of the hand. Characterized by severe soreness and swelling of the palmar surface of the hand, thumb and little finger, as well as a significant restriction of extension of the fingers or its complete inability.
Carpal tunnel syndrome : its onset and clinical manifestations are caused by compression in the carpal tunnel of the median nerve.
Characterized by sharp pain and a sense of numbness, tingling sensation, crawling crawling in the area( paresthesia) of the first, second, third fingers of the hand, as well as the inner surface of the fourth finger.
There is a decrease in the muscle strength of the brush, the sensitivity of the tips of these fingers is reduced.
Pain intensification occurs at night, which leads to sleep disturbance.
There may be some relief when you lower your hand and wiggle it. Quite often there is a discoloration of the skin of the painful fingers( blueness of the tips, pallor).
There may be a local increase in sweating, a decrease in pain sensitivity. When you feel your wrist, swelling and soreness are determined. The forced flexion of the hand and the raising of the hand upwards can cause the aggravation of the pain syndrome and paresthesias in the area of innervation of the median nerve.
Carpal tunnel syndrome is often combined with the Guyon channel syndrome , which is very rare. With the syndrome of the Huyon canal, as a result of the ulnar nerve being compressed in the region of the pea, pain and numbness, tingling sensations, crawling in the IV, V fingers, swelling in the area of the pea and pain when palpable.
Laboratory diagnostics and examination of
Diagnosis of tendovaginitis allows the characteristic localization of the pathological process and the data obtained in the clinical study( cord-like form of painful compaction in typical places, impaired movement, determination of "rice bodies" during palpation).
In a laboratory examination with , acute purulent tenosynovitis in the general blood test( UAC) is defined as leukocytosis( an increase in white blood cells over 9 x 109 / L) with an increase in the content of stab neutrophil forms( above 5%), an increase in ESR( erythrocyte sedimentation rate).
Pus is examined by bacterioscopy( investigation under a microscope after a special coloring of the material) and bacteriological( isolation of pure culture on nutrient media) by methods that enable to establish the nature of the pathogen and determine its sensitivity to antibiotics.
In cases where the course of acute purulent tendovaginitis is complicated by sepsis( when the pathogen is spread from the purulent focus to the blood stream), the blood is tested for sterility, which also allows to determine the nature of the pathogen and determine its sensitivity to antibacterial drugs.
X-ray examination is characterized by the absence of pathological changes from the joints and bones, only thickening of soft tissues in the corresponding area can be determined.
Differential diagnosis of
Chronic tenosynovitis should be differentiated with Dupuytren's contracture( painless progressive flexion contracture of the IV and V fingers of the hand), acute infectious tenosynovitis with acute arthritis and osteomyelitis.
Tendovaginitis: treatment, general recommendations
Treatment of acute tenosynovitis is divided into general and local.
General treatment for
General treatment for with non-specific acute infectious tenosynovitis provides for infection control, for which is used as a pro-bacterial agent, and measures for strengthening the body's defenses are carried out.
When tuberculosis tenosynovitis , anti-tuberculosis drugs are used( streptomycin, ftivazide, PASK and others).
General treatment of with aseptic tendovaginitis involves the use of non-steroidal anti-inflammatory drugs( aspirin, indomethacin, butadione ).
Local treatment, both with infectious , and with aseptic tenosynovitis in the initial stage is reduced to resting the affected limb( is immobilized with gypsum in an acute period of tenosynovitis), application of warming compresses .After it is possible to achieve the abatement of acute phenomena, physiotherapeutic procedures( ultrasound, UHF, microwave therapy, ultraviolet rays, hydrocortisone and novocaine electrophoresis), therapeutic exercise are used.
With purulent tenosynovitis, urgently opens and drains the tendon sheath and purulent feces. In the case of tuberculose tenosynovitis , the local administration of the solution of streptomycin is performed as well as excision of the affected synovial vaginas.
In the treatment of of chronic tendovaginitis , the above-mentioned methods of physiotherapy are applied, and also applications of paraffin or ozocerite, massage and electrophoresis of lidase are prescribed;classes of physiotherapy exercises.
If a chronic infectious process progresses, punctures of the synovial vagina and the administration of directional antibiotics are indicated.
With chronic aseptic tendovaginitis , non-steroidal anti-inflammatory drugs are used, local administration of glucocorticosteroids( hydrocortisone, metipred, dexazone ) is effective. In the case of poorly treatable , chronic crepitic tendovaginitis sometimes resort to X-ray therapy. In some cases, surgical treatment of ( narrowing of narrowed channels) is performed with stenosing tenosynovitis as a conservative therapy.
Tendovaginitis accompanying rheumatic diseases, treated the same way as the underlying disease: prescribe anti-inflammatory and basic drugs, electrophoresis of non-steroidal anti-inflammatory drugs, hydrocortisone phonophoresis.
In case of timely initiated and adequate treatment, tendovaginitis is characterized by a favorable prognosis. However, with purulent tendovaginitis, persistent violations of the function of the affected hand or foot can sometimes remain.
Folk remedies for treatment of tendovaginitis at home
Fociocidulum ( prickly bone without ).It can be used as an external remedy for the treatment of furuncles and tendovaginitis.50 g of finely ground root, boil in 500 ml of water for 30 minutes. Insist 1 hour, strain. Use in the form of trays, compresses and bandages.
The ladder is tenacious .The raw material is a flowering aboveground part, which is dried, pulverized and sprinkled with an abscess or boil, covering with a bandage.
The fragrant fragrant .Kashitsu from the leaves and the aerial part apply under the bandage to the zone of the abscess or with tendovaginitis. Change 2 times a day.
Thinner barbed ( Thistle ).It is applied topically in the form of gruel from aboveground parts. Juice is useful to moisten napkins and apply to a sore spot.
The medicinal hermit .Use this plant as an analgesic for inflammatory skin diseases and abscesses. For external use( compresses, washes), use a hot infusion of 2 tablespoons of raw materials per 500 ml of boiling water. Insist 1 hour, strain. Kashitsu of leaves and flowers can be applied under the bandage for abscesses and boils.
Lily white .Use bulb plants for the treatment of abscesses, boils, tendovaginitov( in the form of gruel, changing every 4-6 hours).To treat wounds and bruises use tincture of lily white flowers( 2 tablespoons per 100 ml of vodka).Insist 3-4 days.
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- Editorial of the article from the site:
- Allega G.N. Official and traditional medicine. The most detailed encyclopedia.- Moscow: Izd-vo Eksmo, 2012.