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tenosynovitis/teno·syn·o·vi·tis/ (-sin″o-vi´tis) inflammation of a tendon sheath.
Trigger finger in children Idiopathic, linked to chromosome defects, secondary to fractures, tendinous or ligamentous lesions
tenosynovitisOrthopedics Inflammation of the tendon sheath and tendon, which may be caused by injury, overuse, strain, or, rarely, by infection. See Trigger finger.
Synonym(s): tendinous synovitis, tendosynovitis, tendovaginitis, tenovaginitis.
tenosynovitisInflammation of a tendon sheath, usually from overuse. There is pain, swelling, limitation of movement and a creaking sensation on movement of the tendon in its sheath. The condition is treated by rest, immobilization and injections of corticosteroid drugs around the affected tendon.
tenosynovitisinflammation of the thin synovial lining of a tendon sheath, as distinct from its outer fibrous sheath. It may be caused by mechanical irritation or by bacterial infection.
tenosynovitisinflammation of tendon and synovial sheath
acute simple synovitis traumatic synovitis; due to over-/unaccustomed use causing tendon and synovial sheath inflammation; characterized by pain/crepitus on movement, local swelling and tendon warmth; treated by rest, appropriate padding and strapping, orthoses, shoe advice (especially for tenosynovitis of extensor hallucis longus)
acute suppurative synovitis infected synovitis due to puncture of the tendon sheath (e.g. a ‘spike’ injury of tendo Achilles) or breakdown of tissue deep to a persistent corn (e.g. overlying prominent extensor hallucis longus tendon; characterized by acute infection (see sepsis); treated as an infected lesion (see Table 1) with systemic antibiosis
chronic simple synovitis; repetitive strain injury; RSI chronic inflammation of tendon/sheath (due to repetitive overuse), together with subserved muscle weakness/wasting; treated as chronic inflammation; note: cause must be established and resolved to achieve permanent resolution
|O||Operate||Remove the cause of the infection where possible, e.g. remove focal hyperkeratosis/foreign body/nail spike|
|C||Cleanse||Irrigate area/cleanse cavity with Warmasol delivered under pressure from a sterile syringe|
|H||Heat||Assist drainage of pus/exudate by applying heat, e.g. immersion in a warm hypertonic NaCl bath|
|A||Antiseptic||Apply a liquid or powder antiseptic (e.g. Betadine)|
|D||Dress||Cover the lesion with a sterile dressing (e.g. sterile gauze; Lyofoam)|
|R||Rest||Impose rest, e.g. deflective padding; shoe modification; walking cast; crutches, as necessary|
|A||Reappoint||Arrange to review case in 24–72 hours|
|R||Review||At the subsequent appointment, review progress|
If resolution has been initiated, continue to treat as above (O–A) and review weekly until healing is complete
If the infection has not improved, arrange for antibiosis, and continue to review and dress until healing is complete
|R||Refer||Refer for specialist review via GP: remember, slow-to-resolve infection can characterize undiagnosed diabetes, or other ‘at-risk’ patient category|
Use all normal preoperative procedures; keep infected lesions covered until ready to treat; take a swab for pathology laboratory analysis of any exudate; use a sterile dressings pack; follow the OCH-A-DRARR treatment mnemonic.
‘At-risk’ patients presenting with infection or patients presenting with acute or spreading infection should be treated using the OCH-A-DRARR protocol, but provided with or referred for immediate antibiosis.