Tendonitis

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Tendonitis
Classifications and external resources
ICD-9 726.90
eMedicine emerg/570 
MeSH D052256

Tendonitis (also spelled tendinitis) is an inflammation of a tendon. Generally tendonitis is referred to by the body part involved, such as Achillies tendonitis (inflammation of the Achilles tendon, or patellar tendonitis (jumper's knee; inflammation of the patellar tendon). Chronic overuse of tendons leads to microscopic tears within the collagen matrix, which gradually weakens the tissue. Tendonitis can also be associated with systemic inflammatory diseases such as rheumatoid arthritis.[citation needed]

Contents

[edit] Diagnosis

Swelling in a region of microdamage or partial tear can be detected visually or by touch. Increased water content and disorganised collagen matrix in tendon lesions may be detected by ultrasonography or magnetic resonance imaging.

Symptoms can vary from an ache or pain and stiffness to the local area of the tendon, or a burning that surrounds the whole joint around the inflamed tendon. With this condition, the pain is usually worse during and after activity, and the tendon and joint area can become stiffer the following day as swelling impinges on the movement of the tendon.

[edit] Treatment

Due to their highly specialised ultrastructure, low level of vascularization and slow collagen turnover, tendons and ligaments are very slow to heal if injured, and rarely regain their original strength. Partial tears heal by the rapid production of disorganised type-III collagen, which is weaker than normal tendon. Recurrence of injury in the damaged region of tendon is common.

Standard treatment of tendon injuries is largely palliative. Non-steroidal anti-inflammatory drugs combined with rest and gradual return to exercise is a common therapy, but there is evidence to suggest that tendonitis is not an inflammatory disorder and that anti-inflammatory drugs are not effective.[1] Perhaps the most promising avenue of therapy is indicated in a line of research finding dramatic rates of recovery including complete remodeling of chronically damaged tendon tissue with eccentric loading.[2][3][4][5][6][7][8][9]

[edit] Medical research

Research suggests that nitric oxide (NO) plays an important role in tendon healing[10] and inhibition of NO synthesis impairs tendon healing.[11] Such findings may lead to improved modes of treatment for this sometimes chronic condition. A potential implication is the supplementing with arginine, the amino acid that the body uses to form NO.[12] Preliminary research also suggests that the injection of stem cells might promote tendon-injury healing.[13] Completely ruptured tendons may be sutured together with or without grafted material.

[edit] Common areas of tendonitis

Tendinous injuries are common in the upper and lower limbs (including the rotator cuff attachments), and are less common in the hips and torso. Individual variation in frequency and severity of tendonitis will vary depending on the type, frequency and severity of exercise or use. In example, rock climbers tend to develop tendonitis in their fingers, swimmers in their shoulders.

Achilles tendonitis is a common injury, particularly in sports that involve lunging and jumping.

A veterinary equivalent to Achilles tendonitis is bowed tendon, tendonitis of the superficial digital flexor tendon of the horse.

[edit] See also

[edit] Footnotes

  1. ^ Khan et al, 2002
  2. ^ Alfredson et al 1998
  3. ^ Mafi et al, 2001
  4. ^ Fahlstrom et al, 2003
  5. ^ Roos et al, 2004
  6. ^ Öhberg et al, 2004
  7. ^ Jonsson & Alfredson, 2005
  8. ^ Wilson & Best, 2005
  9. ^ Rees et al, 2006
  10. ^ Xia et al, 2006
  11. ^ Darmani et al, 2004
  12. ^ UC Berkeley, Wellness Guide
  13. ^ Future Treatments

[edit] External links

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