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In the simple or traumatic form of teno-synovitis, although the most prominent etiological factor is a strain or over-use of the tendon, there would appear to be some other, probably a toxic, factor in its production, otherwise the affection would be much more common than it is: only a small proportion of those who strain or over-use their tendons become the subjects of teno-synovitis.
If the tendon sloughs, the dead portion should be cut away, as its separation is extremely slow and is attended with prolonged suppuration. Gonorrhœal Teno-synovitis. This is met with especially in the tendon sheaths about the wrist and ankle.
#Teno-synovitis.# The toxic or infective agent is conveyed to the tendon sheaths through the blood-stream, as in the gouty, gonorrhœal, and tuberculous varieties, or is introduced directly through a wound, as in the common pyogenic form of teno-synovitis. Teno-synovitis Crepitans.
The affection readily subsides under treatment, but is liable to relapse on a repetition of the exciting cause. Gouty Teno-synovitis. A deposit of urate of soda beneath the endothelial covering of tendons or of that lining their sheaths is commonly met with in gouty subjects.
Reference is here made to the chronic inflammations of the synovial membrane of joints, of tendon sheaths and of bursæ chronic synovitis, teno-synovitis and bursitis; of the fibrous tissues of joints chronic forms of arthritis; of the blood vessels chronic forms of endarteritis and of phlebitis and of the peripheral nerves neuritis.
The accumulation of urates may result in the formation of visible nodular swellings, varying in size from a pea to a cherry, attached to the tendon and moving with it. They may be merely unsightly, or they may interfere with the use of the tendon. Recurrent attacks of inflammation are prone to occur. We have removed such gouty masses with satisfactory results. Suppurative Teno-synovitis.
INJURIES: Contusion; Sprain; Rupture Hernia of muscle Dislocation of tendons Wounds Avulsion of tendon. DISEASES OF MUSCLE AND OF TENDONS: Atrophy; "Muscular rheumatism" Fibrositis; Contracture; Myositis; Calcification and Ossification; Tumours. DISEASES OF TENDON SHEATHS: Teno-synovitis.
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