Causes and symptoms of wrist joint tendovaginitis
Wrist tendovaginitis is an inflammation of the inner lining of the tendons that move the largest joint of the hand. This joint is a movable connection of the bones of the forearm and hand of a person. Pathology can develop as a result of an injury, against the background of constant excessive overstrain of the muscles responsible for the work of the joint, in infectious and rheumatic diseases.
Tenosynovitis can be acute, or it can become chronic with frequent relapses of the disease. The main manifestations of inflammation are pain, tissue swelling and limitation of the hand's motor activity. Since the pathology is capable of leading to a complete loss of the functionality of the limb, the treatment should be timely and complete. If a patient asks for medical help on time, then therapy most often comes down to drug correction. The operation is carried out in exceptional cases.
Statistics indicate that in the general structure of tendovaginitis, hand inflammation is observed in 32% of cases, which is the most frequent indicator.
Content:
- Causes of the wrist joint tendovaginitis
- Symptoms of the wrist joint tendovaginitis
- Diagnostics of the wrist joint tendovaginitis
- Treatment of wrist joint tendovaginitis
- Complex of therapeutic exercises for tendovaginitis of the wrist joint
- Forecast and prevention
Causes of the wrist joint tendovaginitis
Tenosynovitis of the wrist joint can develop due to a variety of reasons, including:
- Tendovaginitis as a result of human professional activity. It is the features of the work that most often lead to inflammation of the synovial membranes of the tendon of the hand. Those people suffer who, due to their duties, perform the same type of repetitive brush movements, over-straining its muscles. At risk for wrist joint tendovaginitis are people working at a computer (operators, machinists), pianists, locksmiths, carpenters, blacksmiths, packers, milkmaids, ironers, seamstresses, etc. The disease most often develops acutely, and later turns into chronic pathology …
- Rheumatic diseases can provoke tendovaginitis of the wrist joint, as well as inflammation of the synovial membranes of tendons of a different localization. In this regard, such pathologies as Reiter's syndrome, ankylosing spondylitis, rheumatoid arthritis, systemic scleroderma, rheumatism are dangerous. The disease most often has an acute course.
- The penetration of bacteria into the cavity of the synovial sheath of the wrist joint tendons leads to violent inflammation. Infection can enter the specified area with the flow of blood or lymph, or during an injury. The danger is represented by various injuries (injections, cuts, abrasions, opened abscesses). If the infection reaches the tendon by the hematogenous route, then its focus can be located in almost any organ.
- In terms of the development of hand tenosynovitis, infections such as brucellosis, tuberculosis, syphilis and gonorrhea can be dangerous. This reason for the development of inflammation is rare, but no less dangerous. In this case, tendovaginitis will act as a complication of the underlying disease.
In connection with the etiological factor that underlies inflammation, there are infectious and aseptic tendovaginitis. With aseptic tenosynovitis, the pathogenic flora does not participate in the development of the disease. Inflammation occurs against the background of irritation of the internal structures of the tendon sheath.
Infectious tendovaginitis is a consequence of the vital activity of pathogenic flora, which enters the synovial sheath of the tendon from the external environment, or from within the body itself. In this case, inflammation is almost always accompanied by the release of pus and a severe course.
In turn, infectious tendovaginitis is divided into specific (provocateurs - gonococcus, Koch's bacillus, treponema) and nonspecific (causative agents of infection - staphylococci, streptococci, pneumococci).
Symptoms of the wrist joint tendovaginitis
Common symptoms of wrist joint tendovaginitis are as follows:
- Pain in the upper limb of varying intensity.
- Swelling of tissues. The stronger the inflammation, the more the swelling will be.
- Redness of the skin in the area of the inflamed tendon.
- Local or general increase in body temperature.
- Hand disorders.
With nonspecific acute tendovaginitis of the hand, a person suffers from severe pain, the swelling increases rapidly. There may also be signs of general intoxication of the body with an increase in body temperature, chills and headache. If purulent inflammation joins, then the pain becomes pulsating, as if "pulling" the tendon from the inside.
With nonspecific tendovaginitis of the hand, the symptoms of the underlying disease will come to the fore. The intensity of pain and swelling of the hand is similar to that observed in acute nonspecific tendovaginitis.
Tendovaginitis of the wrist joint, which was provoked by aseptic inflammation, is most often acute. A person begins to experience severe pain in the hand, which intensifies when trying to make a particular movement. The hand swells, it becomes impossible to move it. Redness of the limb and a local increase in temperature are possible. The forerunners of the development of tendovaginitis of the hand of an aseptic nature may be the feeling that the muscles are being reduced. If the disease becomes chronic, then the pain subsides, bothering the person from time to time. Edema is not observed, but when trying to move the limb, a soft crunch is heard.
Stenosing tendovaginitis is a separate form of hand tendovaginitis. Most often women suffer from it, aged 40 to 50 years. The disease is characterized by the appearance of edema, the muscles at the site of inflammation become denser. The pain occurs after exertion on the arm. In the future, the movements of the fingers begin to suffer, which will be problematic to straighten or bend. When trying to overcome resistance, the person will hear a click. The formation of contracture is the most severe complication of stenosing tendovaginitis.
Carpal tunnel syndrome is another pathology associated with stenosing tendovaginitis. The syndrome develops when the carpal tunnel narrows, which runs in the wrist joint from the side of the hand. The sensitivity of 1, 2 and 4 fingers decreases, the patient cannot perform movements with them. The brush becomes powerless.
De Quervain's disease in which, against the background of stenosing tendovaginitis, the work of the short extensor and the long abductor muscle of the first finger on the hand is disrupted. In addition to the fact that a person will no longer be able to perform the full range of movements with a brush, swelling and pain are observed during an exacerbation of the disease.
Diagnostics of the wrist joint tendovaginitis
Diagnosis of wrist joint tendovaginitis is not difficult. It is enough for the doctor to examine the patient to make the correct diagnosis. The main criteria on which the doctor relies is the characteristic symptomatology of the disease. It is important to find out the nature of tendovaginitis, for which the patient is interviewed in detail.
X-rays of the hand and X-rays of the wrist joint can help clarify the diagnosis. These techniques will provide information about the condition of the joint and bones, which will allow to differentiate tenosynovitis from arthritis and osteomyelitis.
If the doctor suspects that tendovaginitis is a consequence of infection of the body with tuberculosis, syphilis or brucellosis, then he is prescribed the delivery of appropriate tests.
Treatment of wrist joint tendovaginitis
Wrist joint tendovaginitis is treated by such specialists as: orthopedists, surgeons, traumatologists, rheumatologists.
Treatment of acute and chronic aseptic tenosynovitis of the hand. If a patient has aseptic tendovaginitis of the hand in the acute stage, then the limb must be immobilized. It is good if it is possible to maintain an elevated position for the hand.
To reduce pain and relieve inflammation, nonsteroidal anti-inflammatory drugs are prescribed, including: Diclofenac, Indomethacin, Butadion, etc. In parallel, the patient will undergo UHF sessions. When it is possible to get rid of acute inflammation, the patient is shown electrophoresis with novocaine and hormonal drugs. The following procedures have a good effect: treatment with ultraviolet rays, microwave therapy, ultrasound treatment. In order to prevent chronitization of the process, the limb should be protected from stress as much as possible. If due to professional activity it is impossible to do this, then the job should be changed.
When the disease still becomes chronic, the person will have to receive a course of treatment. To do this, for the duration of the exacerbation, the limb is immobilized without fail, after which symptomatic therapy is carried out. In order for relapses to happen as rarely as possible, you need to visit the office of a professional massage therapist, perform gymnastic complexes. Applications with paraffin and ozokerite, electrophoresis with lidase have a good effect.
If the patient has stenosing tendovaginitis, then blockade with hormonal drugs is indicated for its treatment. When the therapy is ineffective, the patient is prepared for surgery to remove the tendon, or to cut it.
Treatment of specific and nonspecific tendovaginitis of the hand. If the disease is caused by a non-specific infectious flora, then the patient must be prescribed antibacterial drugs. In order to reduce pain, analgesics are prescribed. To speed up recovery, the doctor selects immunostimulating drugs for the patient.
When the inflammatory process is accompanied by suppuration, the focus should be opened and the cavity of the synovial sheath of the tendon should be drained.
Provided that tenosynovitis was caused by a specific flora, it is necessary to treat the underlying disease, depending on the sensitivity of the specific pathogen.
Complex of therapeutic exercises for tendovaginitis of the wrist joint
After the acute inflammation has been relieved, you can speed up your recovery by doing a simple set of exercises.
They will also be useful to those people who have had a history of tendovaginitis:
- Put your hand on a flat surface, raise your palm and try to touch the tip of your thumb to the tip of your little finger. Then the palm is lowered. Repeat the exercise 6-10 times.
- The sore hand lies on a flat surface. The palm is raised and with the help of a good hand, it is pulled back, pressing on the fingers. Withstand this tension should be for 10 seconds, then the hand is lowered. Repeat the exercise 3 times.
- A small object is taken into the hand, lifted above the head and rotated in the wrist 3 times clockwise and three times counterclockwise. Then the hand is lowered. The exercise is repeated 3 times. As you train, the weight of the object can be increased.
- The expander is squeezed in the hand for 5 seconds with a break of 2 seconds. Repeat the exercise at least 5 times.
- Pull the elastic over the thumb of the affected hand and the thumb of the healthy hand. Then you need to stretch the elastic band with springy movements, overcoming its resistance. The exercise is performed at least 15 times.
Forecast and prevention
When a patient does not hesitate to seek medical help, the prognosis for full recovery is most often favorable. It is possible to get rid of the disease, on average, in 2 weeks. The patient will need about 14 more days to fully recover.
Provided that the tenosynovitis of the hand is a consequence of professional activity, you need to think about changing jobs. Otherwise, the inflammation will constantly recur, which will lead to severe disorders in the functioning of the limb.
The worst prognosis is when an infection becomes the cause of tendovaginitis. With purulent inflammation in a person, a persistent violation of the hand can form, even after the first episode of tendovaginitis. When the patient ignores the pathological symptoms, it can lead to blood poisoning and death.
Preventive measures aimed at preventing tenosynovitis of the wrist joint:
- During work associated with increased stress on the hand, it is imperative to take breaks, stretching the limb.
- You should avoid performing monotonous movements for a long time.
- At home, you can perform massage and gymnastic complexes.
- Avoid injuries to the upper limbs and joints.
- All infectious processes in the body must be treated.
Compliance with these simple recommendations will prevent the development of tendovaginitis of the wrist joint.
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.
