Tenosynovitis
Alerts and Notices
Synopsis
Tenosynovitis is characterized by the inflammation of both the tendon and synovial sheath. Typically, the hands and wrists are affected, but tenosynovitis may be found with any joint. The etiology includes infection, trauma, inflammatory disease, and strain / overuse. Less commonly, it may be associated with a medication. Infection can be caused by staphylococci, streptococci, gonococci, Mycobacterium avium, and Mycobacterium tuberculosis. Tenosynovitis has also been reported in association with Vibrio vulnificus infection related to traumatic injury in the setting of saltwater fishing. Infection may occur after a wound, puncture, or bite.Trigger finger, or stenosing flexor tenosynovitis, is one of the most common causes of hand pain in adults, and its pathogenesis is often idiopathic.
Signs and symptoms include joint pain, difficulty moving a joint, a slightly flexed finger at rest, edema, and muscle tenderness. Infectious etiologies will include erythema and fever.
Treatment depends on etiology and includes antibiotics, steroid injection, and possibly surgery.
Related topic: de Quervain disease
Codes
ICD10CM:M65.9 – Synovitis and tenosynovitis, unspecified
SNOMEDCT:
67801009 – Tenosynovitis
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Osteoarthritis
- Rheumatoid arthritis
- Psoriatic arthritis
- Dactylitis
- Overuse injury (eg, tendonitis)
- Carpal tunnel syndrome
- Trauma / fracture
- Disseminated gonococcal infection
- Sarcoidosis
- Osteomyelitis
- Atypical mycobacterial infection
- Gout
- Pseudogout
- Reactive arthritis
- Rheumatic fever
- Malignancy (particularly primary bone [osteosarcoma, Ewing sarcoma] and soft tissue)
- Cellulitis
- Bursitis
- Compartment syndrome
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:05/06/2019
Last Updated:09/08/2021
Last Updated:09/08/2021
Patient Information for Tenosynovitis
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Tenosynovitis