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Acute Tenosynovitis

What is tenosynovitis? — Tenosynovitis is the term doctors use when a tendon and the covering around it get inflamed. Tendons are strong bands of tissue that connect muscles to bones. Tenosynovitis happens most often in the hand or wrist. But it can also happen in other parts of the body, such as the ankle.
Different things can cause tenosynovitis, such as:
Using the hand or wrist too much, or doing the same hand or wrist motion over and over
Certain types of arthritis, like rheumatoid arthritis
Infections – Tenosynovitis that is caused by an infection can lead to serious problems. An infection can spread to and damage nearby tissues and muscles.
Sometimes, tenosynovitis happens for no known reason.
What are the symptoms of tenosynovitis? — Symptoms of tenosynovitis can include:
Pain in the fingers, hand, or wrist
Swelling in the fingers or hand
Trouble grabbing or gripping objects
Will I need tests? — Maybe. Your doctor or nurse will ask about your symptoms and do an exam. He or she will examine your hand and fingers carefully and see how they move and work.
Your doctor or nurse might do tests, depending on your symptoms and what's causing your tenosynovitis. Different tests can include:
An imaging test such as an X-ray, ultrasound, or MRI scan – Imaging tests create pictures of the inside of the body.
Blood tests
Lab tests – If you have an infection and a collection of pus around your tendon, the doctor will use a needle to remove some pus. Then he or she will send the sample to a lab for tests.
How is tenosynovitis treated? — Treatment depends on what's causing your tenosynovitis and your symptoms.
Tenosynovitis that is caused by an infection is treated with:
Surgery – During surgery, the doctor will drain the pus, wash out the area around the tendon, and cut away any dead tissue.
Antibiotic medicines
Tenosynovitis that is caused by overuse of the hand or wrist is treated with one or more of the following:
Rest – You should rest your hand and avoid using it. Your doctor might recommend that you wear a brace or splint, or use "buddy taping." Buddy taping is when you tape a finger to the finger next to it (picture 1).
Ice – You can put a cold gel pack, bag of ice, or bag of frozen vegetables on the painful or swollen area every 4 to 6 hours, for 15 minutes each time. If you use ice on your finger, put a towel between the ice and your finger to avoid frostbite.
Pain-relieving medicines called "NSAIDs" – NSAIDs are a large group of medicines that includes ibuprofen (sample brand names: Advil, Motrin) and naproxen (sample brand name: Aleve).
Finger stretches – After your symptoms improve, your doctor or nurse will show you stretches to help your fingers move more easily.
For tenosynovitis that is caused by a type of arthritis, treating the arthritis can help improve symptoms.
If your symptoms don't get better or come back, your doctor might recommend:
Getting a shot of a medicine called a steroid – Steroids help reduce inflammation. These are not the same as the steroids some athletes take illegally.
Surgery to cut or loosen the covering around the tendon
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 82813 Version 8.0
Release: 28.2.2 - C28.105
© 2020 UpToDate, Inc. and/or its affiliates. All rights reserved.

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