Tenosynovitis

• Alternative Names

  Inflammation of the tendon sheath

• Causes, incidence, and risk factors

  The synovium is a lining of the protective sheath that covers tendons. Tenosynovitis is inflammation of this sheath. The cause of the inflammation may be unknown, or it may result from:

  • Infection
  • Injury
  • Overuse
  • Strain

  The wrists, hands, and feet are commonly affected. However, the condition may occur with any tendon sheath.

  Note: An infected cut to the hands or wrists that causes tenosynovitis may be an emergency requiring surgery.

• Symptoms
  • Difficulty moving a joint
  • Joint swelling in the affected area
  • Pain and tenderness around a joint, especially the hand, wrist, foot, or ankle
  • Pain when moving a joint

  Fever, swelling, and redness may indicate an infection, especially if a puncture or cut caused these symptoms.

• Signs and tests

  A physical examination shows swelling over the involved tendon. The health care provider may touch or stretch the tendon, or have you move the muscle where it is attached to see whether you experience pain.

• Treatment

  The goal of treatment is to relieve pain and reduce inflammation. Rest or keeping the affected tendons still is essential for recovery.

  You may want to use a splint or a removable brace to help immobilize the tendons. Applying heat or cold to the affected area should help reduce the pain and inflammation.

  Nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen can relieve pain and reduce inflammation. Local injections of corticosteroids may be useful as well. Some patients need surgery to remove the inflammation surrounding the tendon, but this is not common.

  For tenosynovitis caused by infection, your health care provider will prescribe antibiotics. In some severe cases, surgery may be needed to release the pus around the tendon.

  After recovery, do strengthening exercises using the muscles around the affected tendon to help prevent the injury from coming back.

• Expectations (prognosis)

  Most people fully recover with treatment. However, if the condition is caused by overuse and the activity is not stopped, tenosynovitis is likely to come back. In chronic conditions, the tendon may be damaged and recovery may be slow or incomplete.

• Complications

  If tenosynovitis is not treated, the tendon may become permanently restricted or it may tear (rupture).

  Infection in the tendon may spread to other places in the body, which could be serious.

• Calling your health care provider

  Call for an appointment with your health care provider if you have pain or difficulty straightening a joint or extremity. If you suspect infection, contact your health care provider immediately.

• Prevention

  Avoiding repetitive movements and overuse of tendons may help prevent tenosynovitis.

Review Date: 7/17/2008

Reviewed By: Andrew L Chen, MD, MS, Orthopedist, The Alpine Clinic, Littleton, NH. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.