Tendinitis Disease

DESCRIPTION

Inflammation of tendon occurring usually at its point of insertion into bone or at the point of muscular origin. The inflammation can extend to adjacent bursal tissue.

System(s) affected: Musculoskeletal
Genetics: N/A
Incidence/Prevalence in USA: Common
Predominant age: None
Predominant sex: Male > Female (slightly)

SIGNS AND SYMPTOMS

Pain overlying the point of inflammation. This is usually worsened by active motion, but can be present at rest.
Tenderness over the affected tendon
Mild erythema and increased heat of overlying skin, especially if the tendon is superficial as in the case of the tendo Achilles

CAUSES

Usually related to repetitive activity or trauma, but can be without obvious cause

RISK FACTORS

Professional athletes and manual laborers are especially prone to tendinitis due to repetitive use

LABORATORY

Normal

Drugs that may alter lab results: N/A
Disorders that may alter lab results: N/A

PATHOLOGICAL FINDINGS

Tendinitis is usually associated with some degenerative changes in the tendon under microscopic examinations with presence of fibrinoid, mucoid or hyaline degeneration of the connective tissue

SPECIAL TESTS

Sonogram - this can be an accurate examination when done with real-time machines. Dynamics of the tendon during contraction may be obtained. Exert care that the ultrasound beam does not cross the tendon obliquely.

IMAGING

The CT scan and MRI have replaced even arthrography of the shoulder in most instances. In case where diagnosis is in doubt, especially as regards tendon integrity, an MRI can be obtained and this will usually identify tears, partial tears, inflammation, or tumors. MRI cannot show irregularities of the tendon sheath itself however, and will not diagnose stenosing tenosynovitis or minimal tenosynovitis, unless fluid is present.

DIAGNOSTIC PROCEDURES

N/A

APPROPRIATE HEALTH CARE

Outpatient

GENERAL MEASURES

Treatment goals are to relieve pain, reduce inflammation, rest the joint

SURGICAL MEASURES

N/A

ACTIVITY

In acute phases, the involved muscle and tendon should be put at rest. Use slings and splints for the upper extremity. Use braces, canes, and/or crutches for the lower limbs.
Physical therapy, once patient is free of pain

DIET

No special diet

PATIENT EDUCATION

Explanation of the problem
Instructions for use of supportive devices (e.g., crutches, slings)

PREVENTION/AVOIDANCE

After adequate rest and treatment, prevention of recurrences is important. Splints such as circular bands for forearm extension tendinitis or patella tendinitis may be useful.

POSSIBLE COMPLICATIONS

Tendon rupture or avulsion fractures may occur
Repeated exacerbations of pain. This is probably the most common indication for MRI to confirm the diagnosis and determine the extent of attenuation of the tendon.

EXPECTED COURSE AND PROGNOSIS

The great majority subside without complications

ASSOCIATED CONDITIONS

Bursitis, arthritis - osteophytes may be a factor in traumatizing tendons if located adjacent to a tendon

AGE-RELATED FACTORS

Pediatric: A prevalent form of tendinitis is patellar tendinitis associated with inflammation of the tibial apophysis. Known as Osgood-Schlatter disease, it is seen in adolescents especially during a growth spurt. Splinting with a patella band and restricted activity usually alleviate symptoms. However, some are recalcitrant and may require steroid injections and even surgery with splitting of the patella tendon.
Geriatric: N/A
Others: N/A

PREGNANCY

N/A

OTHER NOTES

N/A

ABBREVIATIONS

N/A

Clinical Investigations

ROLE OF HOMOEOPATHY

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