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inflammation of a tendon and its enveloping sheath (同)tendosynovitis, tendonous synovitis

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/01/31 00:39:33」(JST)

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Tenosynovitis is the inflammation of the fluid-filled sheath (called the synovium) that surrounds a tendon. Symptoms of tenosynovitis include pain, swelling and difficulty moving the particular joint where the inflammation occurs. When the condition causes the finger to "stick" in a flexed position, this is called "stenosing" tenosynovitis, commonly known as "trigger finger". This condition often presents with comorbid tendinitis.

Causes

Tenosynovitis most commonly results from the introduction of bacteria into a sheath through a small penetrating wound such as that made by the point of needle or thorn. Repeated use of hand tools can precede the condition, as well as arthritis or injury. Tenosynovitis sometimes runs in families and is generally seen more often in females than in males. The causes for children are even less well known and have a recurrence rate of less than 1-5% after treatment.^{[citation needed]}

Tenosynovitis is also linked to infectious arthritis caused by bacteria such as Neisseria gonorrhoeae.

Diagnosis

Magnetic resonance images of fingers: psoriatic arthritis with dactylitis due to flexor tenosynovitis. Shown are T1 weighted axial (a) precontrast and (b) postcontrast magnetic resonance images of the fingers from a patient with psoriatic arthritis exhibiting flexor tenosynovitis at the second finger with enhancement and thickening of the tendon sheath (large arrow). Synovitis is seen in the fourth proximal interphalangeal joint (small arrow).

A physical examination shows swelling over the involved tendon. The health care provider may touch or stretch the tendon or have the patient move the muscle to which it is attached to see whether the patient experiences pain.^[1]

Treatment

Treatments for tenosynovitis depend on the severity of the inflammation and location. Mild tenosynovitis causing small scale swelling can be treated with non-steroidal anti-inflammatory drugs (NSAIDs) such as Naproxen, ibuprofen or diclofenac (marketed as Voltaren and other trade names), taken to reduce inflammation and as an analgesic. Resting the affected tendons is essential for recovery; a brace is often recommended.^[2] Physical or occupational therapy may also be beneficial in reducing symptoms.

More acute cases are treated with cortisone (steroid) injections, then a course of paracetamol and ibuprofen for pain. Outpatient surgery can be used to enlarge the synovium. The sprained tendon or limb is splinted for a week or so.^{[citation needed]}

References

^ MedlinePlus Medical Encyclopedia: Tenosynovitis
^ https://health.google.com

External links

http://orthoinfo.aaos.org
Tenosynovitis
RSI - Repetitive Strain Injury and Occupational Overuse Syndrome
Tenosynovitis - Tendon Sheath Inflammation
http://www.nzherald.co.nz
MediLine Plus

UpToDate Contents

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1. 感染性腱滑膜炎infectious tenosynovitis [show details]
… Most cases of infectious tenosynovitis involve the upper extremities; occasionally, infectious tenosynovitis occurs in the lower extremity . Infectious flexor tenosynovitis is more common than infectious …
2. ばね指（狭窄性屈筋腱腱鞘炎）trigger finger stenosing flexor tenosynovitis [show details]
…in that tenosynovitis often leads to swelling and pain along the long axis of the affected tendon, joints, or finger, resulting in limited or painful extension of the involved digit. Tenosynovitis improves …
3. ドケルバン腱鞘炎de quervain tendinopathy [show details]
…the plane of the palm (ie, radial abduction). Similar to trigger finger (or stenosing flexor tenosynovitis), this disease involves a noninflammatory thickening of both the tendons and the tunnel (or sheath) …
4. 糖尿病患者の筋骨格系に生じる合併症の概要overview of the musculoskeletal complications of diabetes mellitus [show details]
…often affected, and the condition is sometimes bilateral . Flexor tenosynovitis is discussed in detail separately. Flexor tenosynovitis has been reported in 5 percent of a series of 250 patients with type …
5. 亜急性または慢性の手首の疼痛を有する成人の評価evaluation of the adult with subacute or chronic wrist pain [show details]
…difficult to manage and should be referred to a hand surgeon. de Quervain tenosynovitis refers to entrapment tendonitis or tenosynovitis of the abductor pollicis longus and extensor pollicis brevis tendons …

English Journal

Ultrasound-guided steroid injection for the treatment of de Quervain's disease: an anatomy-based approach.

Bing JH1, Choi SJ2, Jung SM1, Ryu DS1, Ahn JH1, Kang CH1, Shin DR1.
Skeletal radiology.Skeletal Radiol.2018 Nov;47(11):1483-1490. doi: 10.1007/s00256-018-2958-9. Epub 2018 May 5.
PMID 29730702

MRI of Cuboid Pulley Lesion.

Chang MY1, Hong SH1, Yoo HJ1, Choi JY1, Chae HD1, Moon SJ1.
AJR. American journal of roentgenology.AJR Am J Roentgenol.2018 Oct;211(4):867-871. doi: 10.2214/AJR.17.19497. Epub 2018 Jul 31.
PMID 30063368

Immediate physical therapy without postoperative restrictions following open subpectoral biceps tenodesis: low failure rates and improved outcomes at a minimum 2-year follow-up.

Liechti DJ1, Mitchell JJ1, Menge TJ1, Hackett TR2.
Journal of shoulder and elbow surgery.J Shoulder Elbow Surg.2018 Oct;27(10):1891-1897. doi: 10.1016/j.jse.2018.02.061. Epub 2018 May 25.
PMID 29804912

Japanese Journal

臨床室非結核性抗酸菌症による手指屈筋腱腱鞘滑膜炎の1例

整形外科 = Orthopedic surgery 66(11), 1167-1170, 2015-10
NAID 40020598349

症例手指の結核性腱鞘炎を合併した肺結核の1例

日本呼吸器学会誌 = Annals of the Japanese Respiratory Society 4(5), 408-412, 2015-09-10
NAID 40020592955

専門医試験をめざす症例問題トレーニングリウマチ性疾患,感染症

整形外科 = Orthopedic surgery 66(9), 1013-1016, 2015-08
NAID 40020543006

Related Pictures

Synovitis and Tenosynovitis|Treatment|Recovery|Causes|Symptoms Tenosynovitis - Answers on HealthTap Treatment for De Quervain Tenosynovitis in Augusta GA | Georgia Clinic of Chiropractic De Quervain's tenosynovitis - Symptoms and causes - Mayo Clinic De Quervain’s Tenosynovitis - Causes, Symptoms, Test, Exercise, Surgery DeQuervain’s Tenosynovitis (Mother’s Wrist)

★リンクテーブル★

リンク元	「腱鞘炎」「peritendinitis」「滑液鞘炎」

「腱鞘炎」

Tenosynovitis
Classification and external resources
Specialty	rheumatology
ICD-10	M65
ICD-9-CM	727.0
DiseasesDB	31136
MedlinePlus	001242
eMedicine	emerg/571
MeSH	D013717
	[edit on Wikidata]