Krepitiruyuschie tenosynovitis: causes, symptoms and treatment
Krepitiruyuschie tenosynovitis: causes and features of therapy
The joint is a rather complex mechanical node in the system the human musculoskeletal system.
In his work the involved muscles and tendons. Each tendon is protected by a synovial sheath (vagina), preventing the friction of the tendon on surrounding tissue.
Inflammation of the inner lining of the tendon sheath called tenosynovitis.
Depending on the cause of the problem, the disease differentialsa as:
- infectious (nonspecific, specific);
- aseptic (krepitiruyuschie, constrictive).
The presence of the word «aseptic» in the name of the disease implies inflammation of the synovial sheath of the tendon is not a consequence of any infectious disease organism or the result of infection from the outside of the wound, laceration, puncture.
Aseptic krepitiruyuschie tenosynovitis is significantly different from the infectious tendovaginitis of the origin of the characteristic crackling sound that is heard during palpation of the swollen area or during motor activity of the limbs when the tendon moves across the traumatized synovial membrane. It can be heard even without a stethoscope.
Localization of pathology
Krepitiruyuschie tenosynovitis often affects the synovium of the tendons of the muscles – extensors:
- of fingers (often the thumb);
- of the forearm;
- the wrist;
- Achilles tendon;
What caused the disease?
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Aseptic krepitiruyuschie tenosynovitis is not deterministic infectious diseases of the body, so is considered an independent disease.
The first information about the disease appeared in 1818. In 1867 Russian doctor Yuri Sievert published his work «Tenositis crepitans», where a hypothesis about the connection between disease of the tendons and the occupation of the person.
The cause of the disease he saw as the result of hard monotonous physical stress on the same joints, resulting in injured tendons and adjacent tissue.
Sievert drew colleagues ‘ attention to the fact that loads of this type are those in certain occupations: pianists, typists, porters, workers in heavy industry, in the environment which often identified this malaise. However, studies by J. Sievert at that time few people were interested.
Today not require proof the fact that the same type of movements over a long period of time with the involvement of the same muscle groups often leads to the emergence of krepitiruyuschie tenosynovitis.
The risk group includes not only the workers listed specialties, but also professional athletes, muscle tissue which are often subject to congestion.
The cause of the inflammation can also be the consequence of domestic or sports injuries. That is why this disease is among the professional.
Another reason is the varicose veins because the blood circulation in the tissues adjacent to joints, often leads to degenerative processes in the synovial membrane.
The symptoms and signs of disease
Professional tenosynovitis occurs in two forms:
After excessive loading or injury, the space between health and a classic clinic of the disease fit into a few hours.
But a careful survey of patients often think of some unpleasant feelings of concern 1-2 days before the exacerbation:
- aching or bursting pain;
- burning sensation;
- numbness and unusual weakness aching limbs.
For acute form is characterized by sudden appearance of painful swelling along the injured tendon, the functional limitations of the joint, pain and crepitation on motion, similar to the way the snow creaks under your feet in the frosty winter season.
The acute phase without treatment rather quickly (after 12-15 days) becomes chronic. With decreasing physical activity pain syndrome of dull, crepitus, decrease, or not bugged. In this case, diagnose the disease more problematic.
The obvious is painful, elongated along the channels of the threadlike tendons swelling of elastic consistency, movable with the movement.
Sometimes palpable education in the form of «rice bodies» and fluctuant (feeling with a light but sharp tap on the swelling wave-like fluctuations of the liquid).
The main symptom, which clearly describes krepitiruyuschie tenosynovitis also is muscle weakness, sometimes not allowing you to perform even simple regular task.
Sudden loss of power and is fixed on the dynamometer. This symptom is usually causes the patient to seek medical attention.
The goals and methods of therapy
In the acute stage of the disease need fixing damaged tendons of the joint in functional position by applying splints made from plaster.
Recommended warm compresses, appointed anti-inflammatory non-steroidal drugs:
- procaine blockade with hydrocortisone.
Shown physiotherapeutic treatment: phonophoresis with hydrocortisone, electrophoresis with novocaine and potassium iodide, UHF, microwave therapy, appliques Dimexidum.
In the period decrease in acute stage, the effective application of therapeutic mud, ozokerit. At the same time treatments massage and a gradual increase in physical activity in the form of physiotherapy.
During exacerbation of Chronicles, as in the acute phase, you should provide rest to the injured limb. If the patient is experiencing severe pain, again pain medications are assigned.
Modern approach in treatment of chronic stage of the disease is the use of Nanoplast Forte – anti-inflammatory patch that provides deep heating of all layers of the affected area, improves and restores blood circulation.
After establishing an accurate diagnosis of pain and swelling, at home, can be partially removed by the use of magnetotherapy device (Almag-01) or quantum therapy.
Known cases of successful treatment of occupational tenosynovitis paste of Rosenthal, composed of iodine, ethyl alcohol, paraffin and chloroform.
How to avoid complications
The duration of treatment inflammation takes about two weeks. Even after two weeks of recovery person recovers completely.
If you delay going to the doctor and treatment, the disease develops into a constantly renewing and deepening process.
Moreover, acute inflammation may involve nearby tissues and lead to chronic retidiviruuschem the tendinitis (degeneration of the tendon tissue) or tendomyopathy (muscle imbalance).
Ignored the inflammatory process ultimately can result in the necrosis of the tendon and loss of functionality of the affected limb.
In the prevention of occupational tendovaginitis important special mode of work with a clear schedule short regular breaks for carrying out gymnastic exercises and light massages tired plots.
After stress, coming home, we recommend taking a warm bath, relaxing the muscles.
Athletes before training we should not forget about the special exercises for stretching the tendons in those areas that are most exposed to stress. After training well be applied to overworked tendons compresses with ice.
Any drug and course of treatment chosen by the attending physician individually for each patient.
Preventive measures and timely treatment of inflammation of the synovial membranes of the tendons prevent the occurrence of serious joint problems in the future.