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Tendovaginitis

Tendovaginitis is an inflammation of the synovial tendon sheaths. There are infectious and tendovaginitis aseptic. There are both "dry forms" and exudative, including purulent tendovaginitis. Especially distinguished crepitus and stenosing, as well as brucella tendovaginitis.

Purulent tendovaginitis most often develops on the hands in the synovial vagina of the finger during the transition of the purulent process from the subcutaneous tissue (see Panaritium, tendon ).

In other parts of the body, tendovaginitis may result from injury to the synovial sheaths . Symptoms: uniform swelling, sharp pains at movement and pressure along the tendon sheath , severe intoxication, temperature 38-40 °. The process may be complicated by phlegmon , osteomyelitis, purulent arthritis. After treatment, contractures often remain (see).

Treatment . For purulent tendovaginitis, immediate intervention is necessary: ​​early opening of the tendon sheath with immobilization of a removable plaster bean in a functionally advantageous position, daily warm baths with potassium permanganate . Before cleansing the wound - dressings with a hypertonic solution of sodium chloride, then ointment; Penicillin therapy is indicated - 300 000 IU 4 times a day.

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Fixative tendovaginitis occurs on the limbs (usually on the upper) after prolonged work in people of physical labor (milkmaids, typists, candy wrappers), who have to perform fast and uniform movements in the course of work, due to the participation of a limited number of small muscle groups. Usually the disease occurs in individuals who do not yet have sufficient professional skills. The process proceeds as aseptic inflammation of the synovial vagina. There are pains and swelling along the tendon , most often on the back of the forearm in the distal end of the radial bone and wrist joint , less often on the back of the foot, the anterior surface of the tibia and the ankle , aggravated by movement. When feeling - pain, then there is a characteristic crunch (crepitus), clearly pronounced when moving. Inflammation develops acutely, lasts an average of 4 to 15 days.

Treatment: rest, immobilization with a splint or plaster splint for 6–10 days. From the 4th-5th day, it is removed for the duration of the procedures (warm baths, UHF , sollux, hot water bottle). The ability to work is usually restored 6–9 days after the swelling and crepitus disappear. However, too early resumption of work threatens to relapse.

Prevention of diseases and relapses - periodic, short breaks in the work, during which it is recommended to change the nature of the movements, therapeutic exercises , warm baths, massage. For persons who have not yet fully mastered the profession, the duration of the continuously performed work should be increased gradually.

Stenosing tendovaginitis - aseptic inflammation of the tendon-ligament apparatus of the hand. The cause is a one-time or chronic occupational injury. The disease develops gradually, pains appear at the level of the metacarpophalangeal joints. Flexion and extension of the finger is difficult and occurs with a click ("snapping finger"). Palpable dense formation associated with the tendon.

Treatment: rest (finger immobilization removable plaster Longuet), thermal procedures. In the absence of effect - the operation (dissection of the annular ligament ). The prognosis is favorable.

Brucella tendovaginitis is a form of infectious tendovaginitis. In the region of the tendon sheath, an elastic, rounded swelling of 1 to 3 cm appears on the forearm , painful with pressure. At a pressure, it decreases or disappears due to the movement of exudate through the tendon sheath. Marked swelling of the rear of the hand and crepitus in the lower third of the forearm. The diagnosis is confirmed by specific reactions (see Brucellosis ). Treatment: rest, heat, vaccine therapy. The duration of the disease is 7-14 days. Relapses are possible.