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PubMed1987

Tenosynovitis: tendon and nerve entrapment.

The pathophysiology associated with tendon and nerve entrapment due to idiopathic tenosynovitis of the hand and wrist is discussed. The basis of clinical symptoms, nonoperative and operative treatment, complications, and prognosis relating to stenosing tenosynovitis and carpal tunnel syndrome are reviewed. A systematic approach to developing a philosophy for operative treatment is based upon severity of symptoms and findings at surgery. Deformities of the median nerve are classified into grades that correlate with symptoms and influence selection of the surgical procedure.

Carpal Tunnel Syndrome↗
PubMed1984

Stenosing tenosynovitis of the fingers and thumb. Results of a prospective trial of steroid injection and splinting.

In a prospective study of conservative treatment of stenosing tenosynovitis of the fingers and thumb, 53 fingers and thumbs were injected with 1 cm3 of methylprednisolone and 1 cm3 of 1% lidocaine and immobilized for three weeks. Thirty-eight (72%) of the 53 digits had a successful outcome (mean follow-up period, 25 months). Fifteen (29%) digits in ten patients were only temporarily improved. Treatment was successful in most patients with symptoms and signs of less than four months' duration. Only 41% of the digits causing symptoms for greater than four months had a successful outcome. Patients with multiple-digit involvement did not respond as well (12 satisfactory and ten failed) as those with single-digit involvement (39 satisfactory and two unsatisfactory). The patient with stenosing tenosynovitis in a single digit with less than four months of symptoms responded most favorably to the conservative regimen.

Adult↗
PubMed1983

de Quervain's stenosing tenosynovitis in a video games player.

This report describes a patient who developed signs and symptoms of de Quervain's stenosing tenosynovitis after prolonged playing with video games. An analysis of the biomechanics of video games playing indicates that grasping the joystick controller produces tension on the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons, and that video games playing requires many rapid, repetitive thumb and wrist movements which stress the APL and EPB tendons. It is concluded that prolonged playing with video games should be considered as an etiologic factor in patients with de Quervain's stenosing tenosynovitis.

Adult↗
PubMed1995

Chronic bicipital tenosynovitis in dogs: 29 cases (1985-1992).

Medical records of 23 dogs with unilateral and 3 dogs with bilateral chronic bicipital tenosynovitis were reviewed. Mean age of affected dogs was 4.6 years (SD, 2.0 years), and mean body weight was 32.6 kg (SD, 14.5 kg). Neither a breed nor a gender predilection was detected. All dogs had a history of intermittent or progressive weight-bearing lameness that became worse after exercise. Mean duration of lameness prior to medical or surgical treatment was 6.5 months (range, 0.25 to 24 months). In all dogs, signs of pain were evident during palpation of the biceps tendon within the intertubercular groove. Radiography revealed sclerosis or osteophytosis of the intertubercular groove in all 29 shoulder joints. Mild degenerative joint disease was evident radiographically in 17. Arthrography was performed in 12 joints, and in 11 there were irregularities of or filling defects along the biceps tendon. Arthrocentesis was performed on 17 joints; 14 synovial fluid samples had cytologic abnormalities consistent with degenerative joint disease. Medical treatment, consisting of injection of methylprednisolone acetate into the biceps tendon and its synovial sheath, was attempted in 21 of the 29 affected shoulder joints. Surgery, which consisted of tenodesis of the biceps tendon, was attempted in 14 joints; 8 of these had not been treated medically; the remaining 6 had poor results following medical treatment. Gross and histologic findings consistent with chronic bicipital tenosynovitis were observed in all 14 joints in which surgery was performed. Seventeen of the medically treated shoulders were available for clinical evaluation, and results were excellent or good in 7.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

[Tenosynovitis caused by ciprofloxacin. Clinical case].

We report a 67 years old diabetic female that received ciprofloxacin for an acute pyelonephritis. Twelve days after starting this treatment, a hand and forearm tenosynovitis appeared, that subsided after the discontinuation of ciprofloxacin. Literature review disclosed other reports of tenosynovitis associated with the use of this antimicrobial.

Aged↗
PubMed1995

[Tuberculous tenosynovitis of the wrist: ultrasonographic diagnosis and contribution of MRI].

Chronic tenosynovitis of the hand due to Mycobacterium tuberculosis has become rare. In the two cases presented here, the final diagnosis was obtained by isolation of the organism in the intercarpal fluid (1 case), or by a synovial biopsy (1 case). Ultrasonography showed a hypoechoic thickening of one or several tendon sheaths. MR enabled better differentiation between the thickening of the synovium itself and a fluid effusion. The criteria permitting to differentiate tuberculous from non-infectious tenosynovitis are: young age, male sex, specific epidemiological factors, elevated erythrocyte sedimentation rate, marked local swelling, association with other foci of tuberculosis, unusual exudation and synovial thickening, and association with osteitis.

Adult↗
PubMed1994

Traumatic tenosynovitis and extensor tendon rupture.

Extensor tenosynovitis is caused by a variety of conditions, but most commonly is associated with inflammatory arthritis. Extensor tenosynovitis with secondary tendon rupture due to occupational repetitive direct trauma to the dorsal compartments of the wrist and hand is reported in a woman. Tenosynovectomy and tendon transfer were performed to relieve pain and restore hand function.

Adult↗
PubMed1994

Tuberculous tenosynovitis of the wrist mimicking de Quervain's disease.

We describe a rare case of tuberculous tenosynovitis involving the first dorsal compartment at the wrist mimicking de Quervain's disease. Differentiation between tuberculous infection and de Quervain's disease is important since corticosteroid injection, appropriate in the latter, is detrimental in tuberculous tenosynovitis. Early culture and biopsy in suspicious cases provide accurate diagnosis.

Adult↗
PubMedDate not supplied

Pigmented villonodular tenosynovitis of the temporomandibular joint.

A case report of pigmented villonodular tenosynovitis involving the temporomandibular joint is presented. The lesion had destroyed the ascending ramus and condyle of the mandible, anterior cartilaginous wall of the external auditory meatus, and a large part of the squamous portion of the temporal bone. Surgery included resection of a portion of the mandible, temporal squama, and dura of the temporal lobe with replacement by a fascia temporalis graft. Four years postoperatively, the patient is free of any evidence of recurrent disease. A discussion of the differential diagnosis of an infratemporal mass, natural history, and pathology of pigmented villonodular tenosynovitis are discussed herein.

Diagnosis, Differential↗
PubMed1996

Peroneal tenosynovitis following acute gonococcal infection.

A 17-year-old adolescent girl presented with tenosynovitis of the peroneal tendons following diagnosis and treatment of an endocervical gonococcal infection. The need for careful history in any sexually active adolescent is emphasized. Acute peroneal tenosynovitis, although not previously cited in the literature, can occur and should be suspected.

Acute Disease↗
PubMed1997

Corticosteroid responsive tenosynovitis is a common pathway for limited joint mobility in the diabetic hand.

OBJECTIVE: To test the hypothesis that diabetic tenosynovitis participates in the contractures of the syndrome of limited joint mobility (SLJM). METHODS: Adults with diabetes mellitus were referred for the evaluation of diabetic hand conditions. Patients with SLJM or diabetic trigger finger were studied after Dupuytren's contracture, hand neuropathy, carpal tunnel syndrome, and arthritis were excluded. A time series design was employed in which patients were observed for 3 mo to obtain a baseline, then the planar flexor tendon sheaths were injected with 10 mg of methylprednisolone acetate or 10 mg triamcinolone acetonide and were reassessed at 1, 3, and 12 mo. RESULTS: Response rates, defined by complete resolution of digital contractures and triggering after corticosteroid injection, were 94% (31/33), 76% 28/33), and 61% (17/29) at 1, 3, and 12 mo, respectively, which were all significantly different from preinjection (p < 0.001). Individual response rates for SLJM and trigger finger were similar. No appreciable differences between methylprednisolone acetate and triamcinolone acetonide were observed, although there was a trend for earlier recurrence with methylprednisolone. CONCLUSION: Corticosteroid injection is a safe and effective therapy that should be considered in patients with SLJM or diabetic trigger finger. The excellent response to injection indicates that diabetic tenosynovitis is a common pathway in diabetic hand conditions.

Adrenal Cortex Hormones↗
PubMed1976

Stiffness of the proximal interphalangeal joints in rheumatoid arthritis. The role of flexor tenosynovitis.

In nineteen hands (seventy-four fingers) of eleven women and one man with rheumatoid arthritis there was restriction of active and passive motion of the proximal interphalangeal joints, with signs of flexor tenosynovitis but no clinical or roentgenographic evidence of involvement of the joint. The nineteen hands were treated by flexor tenosynovectomy (palm only in nine, palm and carpal tunnel in five, both palm and digits in four, and digit, palm, and wrist in one) combined with manipulation of the joint under regional anesthesia. After an average follow-up of twenty-one months (range, six to thirty-six months), the average range of active motion had increased from 40 to 84 degrees and the average range of passive motions, from 57 to 87 degrees. Only three patients had unsatisfactory results, one because of persistent unexplained swelling and two because of recurrence of the tenosynovitis.

Adolescent↗
PubMedDate not supplied

Hemochromatotic arthropathy mimicking rheumatoid arthritis. A case with subcutaneous nodules, tenosynovitis, and bursitis.

A 63-year-old man developed symmetrical polyarthritis, subcutaneous nodules at the elbows, olecranon bursitis, and recurrent tenosynovitis. He was later discovered to have idiopathic hemochromatosis. Staining of the subcutaneous nodule revealed iron deposits. These manifestations which are common to rheumatoid arthritis may be seen in hemochromatotic arthropathy.

Arthritis↗
PubMed2007

Calcific myonecrosis and tenosynovitis: sonographic findings with correlative imaging.

We report the sonographic appearance of a case of calcific myonecrosis and tenosynovitis with correlative plain radiography and CT findings. Calcific myonecrosis is a rare complication of previous trauma that presents as a tumor-like calcified mass years after an initial injury, most commonly affecting the anterior compartment of the lower leg. Although the clinical, radiographic, and MRI features of calcific myonecrosis have been well described, to our knowledge the sonographic appearance has not been reported previously in the literature.

Calcinosis↗
PubMed1987

Semimembranosus tenosynovitis: operative results.

Semimembranosus tenosynovitis is a common knee problem in the over-50 age-group, occurring mainly in women. It affects the reflected portion of the tendon of the semimembranosus muscle as well as the bursa below it. The tendon becomes inflamed as a result of friction at the entrance to the bony canal (semimembranosus groove), especially if osteophytes are present on the edges of the groove. Conservative treatment includes anti-inflammatory drugs, ultrasound, and friction massage. If necessary, nonresponders may be given local injection of 40-80 mg methylprednisolone acetate with 1% Xylocaine. Between 1979 and 1983 we operated on 16 patients who had not obtained relief even after three or four injections. The approach in each case was through a posterior medial oblique incision. The semimembranosus osteofibrotic tunnel was revealed and the fibrous sheath surrounding the tendon was excised. Good results were obtained in eight patients in whom the inflammatory process had been localized to only the semimembranosus insertion area: eight patients in whom the knee joint or the pes anserinus insertion was also involved achieved fair or poor results. The operation is not advised for young athletes because of the important function of the reflected head of the semimembranosus muscle.

Diagnosis, Differential↗
PubMed1984

Infectious tenosynovitis in broilers and broiler breeders in Egypt.

Two infectious tenosynovitis-producing viruses were isolated from tendon sheaths and synovial fluids of 59 broilers and 15 broiler breeders obtained from different flocks in Egypt during June to October 1983. The viruses grew well on the chorioallantoic membrane of developing chicken embryos, produced small localized white pock lesions with oedematous swellings at the inoculation sites and death of most of the embryos 72 to 96 hours post-inoculation. They also induced cytopathic effect in chicken embryo rough, Vero and MS cell lines. The viruses were neutralized by reovirus S1133 antiserum, both in tissue culture and on the chorioallantoic membrane. Inoculation of the viruses into 2-day-old broiler chicks via the foot pad, intramuscular and oral routes reproduced the disease with the development of characteristic clinical, pathological and serological responses. The infection was transmitted to in-contact control chicks. This is the first report of the disease and of the isolation and identification of the causative virus in Eqypt.

Animals↗