Ankle (foot) Tendovaginitis - Causes, Symptoms And Treatment

2024 Author: Josephine Shorter | [email protected]. Last modified: 2023-12-16 21:43

Causes and symptoms of ankle tendovaginitis

Ankle tendovaginitis is an inflammation of the synovial membrane of the vagina that covers the tendon and is responsible for movement of the foot. The inflammatory process can be acute and chronic, accompanied by the onset of symptoms such as pain, swelling, limitation of limb movement, etc.

The causes of tendovaginitis of the ankle joint are varied, most often the pathology manifests itself as a result of the teaching of an injury, or against the background of infection in the tendon sheaths. If a patient seeks medical help in a timely manner, then most often it is possible to cope with the disease with the help of drug correction.

The synovium that surrounds the tendons of the foot can be located on the dorsum or plantar part of the foot. The consequences of untreated inflammation can be the saddest, up to the complete loss of limb functionality. As a result, a person can become disabled. Therefore, when the first signs of the disease appear, you should consult a doctor.

Content:

• Causes of ankle tendovaginitis
• Ankle tendovaginitis symptoms
• Diagnostics
• Ankle tendovaginitis treatment
• Prognosis and possible complications of ankle tendovaginitis

Causes of ankle tendovaginitis

The causes of ankle tendovaginitis can be as follows:

• Received microtrauma of the tendon sheaths of the foot. This occurs against the background of pronounced loads, or with an anatomical violation of the ratio of the structures of the foot. Athletes, speed skaters, tap dancers, ballerinas are at risk for the development of tendovaginitis of this localization.
• Flat feet can lead to the development of tenosynovitis of the foot. This also includes congenital and acquired deformities of the lower extremities (calcaneal, equine, hollow foot, clubfoot, etc.).

Therefore, additional risk factors for the development of inflammation of the synovial bags can be considered:

• Rickets;
• Polio;
• Wearing high-heeled shoes;
• Obesity;
• Standing work;
• Aging of the body;
• Hereditary weakness of the ligamentous apparatus;
• Insufficient physical activity.
• The presence of a focus of purulent infection in the body. In this case, the pathogenic flora enters the tendon with the blood flow, or through direct contact with tissues and begins to multiply in the synovial bags. They constantly produce fluid, which is a favorable environment for increasing the number of bacteria.

Danger in this regard can be represented by pathologies such as:

• Felon;
• Purulent arthritis.
• Injury of the foot with the penetration of infection into it;
• Osteomyelitis;
• Phlegmon;
• Abscess, etc.
• Inflammation of the tendons of the foot can develop with the following diseases: flu, gonorrhea, tuberculosis, brucellosis. In this case, infectious agents penetrate the synovial sheaths of the foot with the blood flow.
• Diseases of a rheumatic nature are another risk factor in terms of the development of foot tendovaginitis. Such pathologies include ankylosing spondylitis, systemic scleroderma, Reiter's syndrome, rheumatism and rheumatoid arthritis.
• Injuries to the bones and soft tissues of the foot are dangerous because pathogenic flora can enter them, which can cause inflammation. This happens with deep burns, with a splinter in the leg, with stab and laceration wounds, with fractures and ruptures of tendons with a violation of the integrity of the skin.

• Performing a pedicure with non-sterile instruments should be noted separately, since it is this reason that often leads to the development of tendovaginitis in women. During cuticle trimming with non-sterility rules, the infection can get under the nail. In the place where the skin is in contact with the nail plate, sweat and sebum accumulate, which is a favorable environment for the development of bacterial flora. As a result, a purulent focus forms in the toe, which in the future can lead to the development of foot tendovaginitis.

Ankle tendovaginitis symptoms

The symptoms of ankle tendovaginitis are as follows:

• Pain. Painful sensations intensify during any movement of the foot, including when walking. The pain is acute, localized in a strictly designated place, namely, in the area of the inflamed tendon. The farther the muscles are from the focus of inflammation, the less intense the painful sensations will be. If tendovaginitis is accompanied by an accumulation of purulent masses, then the pain will be pulsating, twitching from the inside.

• Puffiness. As the blood vessels overflow with blood, they become permeable. The liquid from them is released into the tissue of the foot, thereby forming edema. The swelling grows rapidly, literally a few hours after the onset of pain, the limb can double in size. Sometimes, due to the strong stretching of the tissues, the skin in the affected area becomes covered with small cracks.
• Hyperemia of the skin. Redness is located clearly over the inflamed tendon, which is caused by the expansion of the blood vessels.
• Crunching can occur when pressure is applied to inflamed bursae.
• Local hyperthermia. The temperature of the skin rises in the area of inflammation, which is explained by a sharp rush of blood.
• Restricted ankle mobility.
• If the inflammation is purulent, then the patient has an intoxication of the body as a whole, his body temperature rises, weakness and malaise are observed.

It cannot be ruled out that the acute form of tendovaginitis will become chronic. In this case, the person will suffer from pain and limitation of limb movement. During the examination of the patient, the doctor visualizes a cord-shaped formation located under the skin. Sometimes you can palpate small grains, which are a symptom of tuberculous tendovaginitis.

Diagnostics

To clarify their suspicions about foot tendovaginitis, a person may seek advice from a therapist or orthopedist. In the future, he can be referred to a rheumatologist or surgeon.

To determine the diagnosis, the doctor performs the following activities:

• Visual examination of the patient. In addition, the doctor palpates the affected area and checks the reflexes.
• Patient interview.
• Blood sampling for general analysis. In acute inflammation, accompanied by suppuration, an increase in ESR and the number of neutrophils will be observed in the blood.
• Bacterioscopic and bacteriological examination of exudate from inflamed synovial bags. The collection of fluid is performed during puncture.
• X-ray examination, CT and MRI. These studies make it possible to clarify the absence of bone or articular pathology.

Ankle tendovaginitis treatment

Treatment of ankle tendovaginitis is determined by the form of the disease. First of all, it is necessary to stop acute inflammation and relieve pain in order to alleviate the person's condition.

So, in the acute phase of tendovaginitis, the following activities are shown:

• The limb should be in absolute rest. The leg should be elevated using immobilization devices. This can be a plaster cast or an elastic bandage.
• Prescribing antibacterial drugs. The doctor chooses a drug empirically, if a bacteriological study of the exudate from the synovial bags has not been carried out before.
• Prescribing drugs to increase immunity will allow you to quickly get rid of inflammation.
• Drugs from the NSAID group: Indomethacin, Diclofenac, Butadion, etc. They relieve pain and help to eliminate the inflammatory response.
• If tendovaginitis develops against the background of infection of the body with tuberculosis, then treatment is carried out aimed at eliminating the underlying infection. The same statement is true for syphilis and brucellosis.
• Acute suppurative inflammation with widespread occurrence requires an emergency operation. In this case, the wound is opened, drained and sanitized. The doctor should carefully examine the wound surface to make sure there are no fistulas or purulent pockets.

After the acute phase is eliminated, the patient is recommended to undergo a course of physiotherapy.

Patients with tendovaginitis are shown the following measures:

• UHF;
• Electrophoresis with analgesics and hormonal drugs (hydrocortisone + novocaine);
• Electrophoresis with lidase;
• Massage;
• Implementation of a complex of physiotherapy exercises;
• Applications with paraffin and ozokerite;
• Mud treatment.

Provided that therapy does not bring the desired results, and relapses occur frequently, it is necessary to prepare the patient for surgery. It is performed in a planned manner. During surgery, the tendon is excised, and the wound and dissected tissue are sutured. The recovery period lasts 14 days. At this time, the patient receives antibiotic therapy, performs gymnastic complexes, attends physiotherapy sessions. If the operation is successful, the patient can fully recover.

Physiotherapy

Therapeutic gymnastics for tendovaginitis is performed with the aim of strengthening the tendons and relieving tension from them.

To do this, you can practice the following exercises:

• Walking on toes, on the outside and inside of the foot, on the heels. The time of medical walking can be equal to 10-15 minutes.
• With the help of a rubber band, they tie the feet and try to spread them in different directions, stretching the elastic as much as possible. At this time, the person should sit on a chair with a back.
• Performing circular movements with the feet clockwise and counterclockwise. You need to perform 15 rotations in one direction and 15 rotations in the other direction.
• Jumping rope. To maximize the load on the ankle tendons, you need to bounce without bending your knees.
• Lifting small objects with your toes.

Before exercising, you should consult your doctor. This is especially true for people who have suffered an injury or surgery on the lower limb.

Prognosis and possible complications of ankle tendovaginitis

The prognosis for tendovaginitis of the foot is most often favorable. If the patient seeks medical help in a timely manner, he will recover as soon as possible. Provided that the inflammation is due to professional characteristics, then you should think about changing jobs. Otherwise, relapses of the disease cannot be avoided.

With a severe course of tendovaginitis, as well as in its advanced stage, the following complications may develop:

• Formation of contractures and fistulas.
• Ligament stenosis.
• Formation of an abscess.
• Overgrowth of connective tissue.
• Sepsis.

If the disease is not treated, then the functionality of the foot can be completely lost.

Meanwhile, preventive measures are not at all difficult. They boil down to avoiding excessive stress on the ankle tendons, for which you need to take at least short breaks in work. At home, you can also perform massage and therapeutic exercises. If you get a foot injury, you should take care of its high-quality disinfection. When performing a pedicure, you need to monitor compliance with sanitary and hygienic standards and remember about sterility.

The author of the article: Volkov Dmitry Sergeevich | c. m. n. surgeon, phlebologist

Education: Moscow State University of Medicine and Dentistry (1996). In 2003 he received a diploma from the Educational and Scientific Medical Center of the Presidential Administration of the Russian Federation.