Chronic tendovaginitis
Chronic tendovaginitis often occurs as a complication of acute tendovaginitis and requires special attention from specialists. With a competent approach to treatment and early diagnosis, the disease has a favorable prognosis. An important role in the early relief of symptoms of chronic tendovaginitis is played by a timely visit to a doctor.
Localization, symptoms and forms of chronic tendovaginitis
Inflammation in chronic tendovaginitis in most cases is localized in the sheaths of the tendons that are responsible for the extension and flexion of the fingers in the place of their retainers. Most often, the clinic of the disease manifests itself in the common synovial vagina of the fingers, which is located in the canal of the wrist. Here you can feel an elongated elastic tumor. On palpation, fluctuation and characteristic "rice bodies" can be seen. The movement of the tendons is limited and painful.
One of the forms of chronic tendovaginitis is stenosing tendovaginitis, which is characterized by lesions of the sheath of the tendons of a certain abductor muscle and the short extensor of the thumb on the hand: its walls become thicker, and the lumen of the synovial cavity decreases.
Among the first symptoms of chronic tendovaginitis, soreness in the area of the styloid process of the radius is noted. On palpation along the vagina, you can find a tumor, the palpation of which is accompanied by acute pain. Abduction and flexion of the thumb is also accompanied by pain radiating to the shoulder and forearm.
The clinic of stenosing tendovaginitis has much in common with stenosing ligamentitis. With stenosing ligamentitis, inflammation affects the ligamentous apparatus of the hand. The disease becomes a consequence of overexertion, trauma, infections.
Inflammation in this case is localized in the area of the collateral ligaments of the metacarpophalangeal and interphalangeal joints of the hand. Palpation of the foci and movement of the joints are accompanied by pain, swelling, edema and redness of the skin are noted at the site of inflammation. In some cases, the disease causes a part of the ligaments to become numb, which leads to a decrease in the sliding of the tendon and causes difficulty in moving the finger, the flexion and extension of which is accompanied by a specific click.
Tuberculous tenosynovitis is diagnosed by palpation. When probing the tendon sheaths, "rice bodies" dense in consistency are noted.
Treatment of chronic tendovaginitis
Chronic tenosynovitis is successfully treated with physiotherapy procedures, as well as paraffin compresses, mud baths. Patients are shown massage, electrophoresis using lidase. Physical therapy helps to restore joint mobility. If the pathological process intensifies over time, then it becomes necessary to puncture the synovial vagina and prescribe antibacterial agents and medicines from the group of non-steroidal anti-inflammatory drugs, novocaine and hydrocortisone are injected directly into the area of inflammation.
If the disease is difficult to treat, X-ray therapy sessions help, their number should not exceed two. In order to expand the lumen of the tendon sheath with stenosing tendovaginitis, doctors may cut a separate section of it.
As complications in purulent tendovaginitis, one can note stable changes in the functions of the hands or feet.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".
