Article
Clinical-ultrasonographic diagnosis of chronic tenosinovitis in the field of hand and wrist joint
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Authors
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Iryna Kondrashova
- Dnepropetrovsk city clinical hospital 16, Dnepro, Ukraine
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Vyacheslav Logvinenko
- Dnepropetrovsk regional clinical hospital I.I. Mechnikov, Dnepro, Ukraine
| Published: | February 6, 2020 |
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Outline
Text
Clinical issue/s: Today chronic tenosinovitis in the area of the hand and the carpal joint accounting for 12 % among of all degenerative-dystrophic hand diseases by frequency of appeal for specialized medical care.
Objective of research: To show the possibility of ultrasound diagnosis of chronic tenosinovitis as an objectively qualitative, accessible and effective modern method of research.
For 2015-2018 years we examined 82 patients with chronic tenosinovitis of the hand and forearm, in 8 cases they were as a manifestation of the general desease: in 5 patients - gout, 1 patient - systemic scleroderma, 2 - psoriasis.
As a separate nosological unit, 42 patients have been diagnosed with Kerven's disease. Ultrasonography was carried out on the Voluson 730 Pro devices by a multi-frequency sensor 6-12 MHz. The results of the ultrasonographic study were confirmed intraoperatively.
Innovative, analytical or new approach: Clinical manifestations of tenosinovitis - puffiness and crepitation in the projection of the tendon, specific pain in the site of it attachment, pain with active contraction and resistance. Clinical manifestations of De Kerven's disease - limited extension function and pain in first finger, loss of elbow deviation of the wrist, blocked of abductor policis longus tendon, positive Finkelstein test.
Ultrasound manifistations of tenosinovitis as an independent disease - thickening of the tendons and their synovial membranes, a small amount of fluid in the synovial vagina, round form in the cross section. As a manifestation of systemic diseases they have their own peculiarities:for gouty tenosinovitis characterized by thinning of the tendons, deposition of uric acid salts, for scleroderma - associated with lysis of tendons in places attached to the phalanges.
Contribution to advancing HT practice: The possibilities of ultrasound with the correct interpretation of the sonographic picture allow for a clear differential diagnosis the acute and chronic process, and to recognize tenosinovitis, as a syndrome of a general disease.
