Inflammation of the tendon sheath: Definition, signs, origins, and additional details
Tenosynovitis, a condition characterised by inflammation of the tendon sheath, can cause discomfort and affect the mobility of affected joints. This inflammation results in the protective covering around a tendon becoming swollen, leading to "catching" and "locking" joints.
Tenosynovitis differs from tendinitis, where the tendon itself becomes inflamed. Understanding these differences is crucial for accurate diagnosis and treatment.
Causes and Risk Factors
Tenosynovitis is often caused by repetitive mechanical overload and occupational activities that involve repetitive hand motions, such as pinching, wringing, lifting, and grasping, particularly in the wrist and thumb. Trauma or injury to the tendon region can also initiate tenosynovitis.
Systemic inflammatory diseases, like rheumatoid arthritis and psoriatic arthritis, can cause tenosynovitis by triggering inflammation of the tendon sheath. Female sex and hormonal changes, especially during pregnancy and menopause, are associated with a higher incidence of tenosynovitis.
Anatomical variations, such as septation in the wrist compartment or bony features of the radius, may increase friction and susceptibility to tenosynovitis. Other risk factors include age-related degeneration and repetitive microtrauma that exceed the tendon’s repair capacity.
Differences between Tenosynovitis and Tendinitis
| Aspect | Tenosynovitis | Tendinitis | |----------------------|---------------------------------------|---------------------------------------| | Anatomical focus | Inflammation of tendon sheath (synovium) | Inflammation of the tendon tissue itself | | Common etiologies | Repetitive stress, trauma, systemic inflammation affecting sheath | Overuse, strain, aging leading to tendon microtears and degeneration | | Pathology | Sheath thickening, synovial inflammation, possible fluid accumulation | Tendon fiber inflammation, collagen disruption, and degeneration (tendinosis if chronic) | | Examples | De Quervain’s tenosynovitis, trigger finger | Rotator cuff tendinitis, Achilles tendinitis |
Prevalence in Rheumatoid Arthritis
Up to 87% of people with rheumatoid arthritis show features of tenosynovitis on MRI scans, highlighting its prevalence in this population.
Summary
Tenosynovitis is a condition that often involves inflammatory swelling of the tendon sheath, driven mainly by overuse, trauma, or systemic inflammatory conditions. Tendinitis, on the other hand, is primarily inflammation or degeneration of the tendon tissue itself. Both share some risk factors, but the affected structures and pathological processes differ.
Tenosynovitis can occur in any tendon that has a sheath surrounding it, including the hands, wrists, feet, and ankles. It can result from different factors, and experts divide it into two main types: infectious and noninfectious. Noninfectious types can occur due to autoimmune factors, overuse, systemic diseases, or can be idiopathic.
In cases of advanced tenosynovitis, a person may present with visible contracture deformities and an inability to relax the tendons. About 10-20% of people with diabetes also develop tenosynovitis.
It's essential to seek medical advice if experiencing symptoms of tenosynovitis, as early treatment can help prevent further complications.
- The inflammation of the tendon sheath, as seen in tenosynovitis, can cause discomfort and affect the mobility of affected joints, differentiating it from tendinitis where the tendon itself is inflamed.
- Understanding the differences between tenosynovitis and tendinitis is crucial for accurate diagnosis and treatment, as they involve distinct anatomical focus, common etiologies, and pathology.
- Tenosynovitis can be caused by a variety of factors including repetitive mechanical overload, systemic inflammatory diseases, anatomical variations, and age-related degeneration, making it prevalent in conditions like rheumatoid arthritis.
- Adequate therapies and treatments are available for managing tenosynovitis, with the focus on addressing the underlying cause, reducing inflammation, and alleviating pain. These interventions may include medications, physical therapy, and in some severe cases, surgical procedures.
