Tenosynovitis

Tenosynovitis
ICD-10	M65
ICD-9	727.0
DiseasesDB	31136
MedlinePlus	001242
MeSH	D013717

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Associate Editor-In-Chief: M.Umer Tariq [3] Kiran Singh, M.D. [4]

Synonyms and keywords: Tendon sheath inflammation; inflammation of the tendon sheath

Overview

Tenosynovitis is the inflammation of the fluid-filled sheath (called the synovium) that surrounds a tendon. Symptoms of tenosynovitis include pain, swelling , and difficulty moving a particular joint where the inflammation occurs. When the condition causes the finger to "stick" in a flexed position, this is called "stenosing" tenosynovitis, which is commonly called "Trigger Finger."

When the finger tendon is inflamed, the synovium swells. Sometimes the tendon cannot slide easily through the synovium. When you straighten your finger, the tendon locks or sticks as it squeezes through the too-small synovium.

It usually occurs with tendinitis and it is related to stenosing tenosynovitis.

Causes

Causes of trigger finger are unknown. Repeated use of hand tools can precede the condition, as well as arthritis or injury. Trigger Finger sometimes runs in families, and is generally seen more often in males than in females. The causes for children are even less known and have a recurrence rate of less than 1-5% after treatment.

(By organ system)

Cardiovascular	No underlying causes
Chemical / poisoning	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	Pergolide, Pramipexole, Rasagiline
Ear Nose Throat	No underlying causes
Endocrine	No underlying causes
Environmental	No underlying causes
Gastroenterologic	No underlying causes
Genetic	No underlying causes
Hematologic	No underlying causes
Iatrogenic	No underlying causes
Infectious Disease	Gonorrhea,
Musculoskeletal / Ortho	No underlying causes
Neurologic	No underlying causes
Nutritional / Metabolic	No underlying causes
Obstetric/Gynecologic	No underlying causes
Oncologic	No underlying causes
Opthalmologic	No underlying causes
Overdose / Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	No underlying causes
Renal / Electrolyte	No underlying causes
Rheum / Immune / Allergy	DeQuervain's syndrome, Polymyalgia Rheumatica,
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	No underlying causes
Miscellaneous	No underlying causes

(In alphabetical order) Other causes and associated conditions are:

• DeQuervain's syndrome
• Gonorrhea
• Pergolide
• Polymyalgia Rheumatica
• Trigger finger

Diagnosis

History and Symptoms

• Problems moving joints
• Pain, swelling and tenderness around a joint, particularly the hand, wrist, foot, and ankle
• Pain when moving the affected joint

Physical Examination

A physical examination shows swelling over the involved tendon. The health care provider may touch or stretch the tendon or have you move the muscle to which it is attached to see whether you experience pain.

Thumb

• 
  Tenosynovitis nodular. Adapted from Dermatology Atlas.
• 
  Tenosynovitis nodular. Adapted from Dermatology Atlas.
• 
  Tenosynovitis nodular. Adapted from Dermatology Atlas.
• 
  Tenosynovitis nodular. Adapted from Dermatology Atlas.

Treatment

Possible treatments for tenosynovitis include cortisone injections (then a course of paracetomal and ibuprofen for pain) and an outpatient surgery to enlarge the synovium. The hand is splinted for a week or so.

Related Chapters

• Synovitis
• DeQuervain's syndrome