Tendon pathology
Updates to Article Attributes
A number of processes can affect tendons.
Tendinopathy (tendonopathy)
Literally means a disease or disorder of a tendon and typically used to describe any problem involving a tendon. While many define tendinopathy as an umbrella term to describe all tendon pathology, others may use it to describe a chronic tendon condition that fails to resolve.
Tears and myxoid degeneration
Tears are common and are categorised as:
- complete or incomplete (partial)
- full thickness or partial thickenss
- horizontal or longitudinal (split)
- hypertrophic or atrophic (more serious)
The MRI characteristics are of change in shape of the tendon (thickened, thinned) as well as increase in signal on both T1WI and T2WI. Unfortunately these features are indistinguishable from myxoid degeneration.
The term tendinopathy is therefore preferred. (NOT tendinitis as no inflammatory component is usually present).
Prediposing factors to tendon rupture
- age
- chronic use / overuse
- acute trauma
- diabetes mellitus
- rheumatoid arthritis and other inflammatory arthropathies.
- chronic renal impairment
- steroid use
- infection
- gout
Tendinitis
Use to describe situations where there is inflammation of the tendon.
Tendinosis
Usually implies a non-inflammatory degeneration of a tendon. This degeneration can include changes to the structure or composition of the tendon.
Tenosynovitis
Should only be called if fluid is seen surrounding the entire tendon. A mesotendon may be seen as a thin low intensity band. If the tendon communicates with a joint, such as the long head of biceps at the shoulder, and flexor hallucis longus at the ankle, then no fluid should be present in the joint to make the call.
If the fluid is loculated the term stenosing tenosynovitis can be applied. This is most commonly seen in
- flexor hallucis longus in patients with os trigonum syndrome
- de Quervain stenosing tenosynovitis
Dislocation or subluxation of tendons
-
wrist
- extensor carpi ulnaris (medial)
-
shoulder
- long head of biceps (medial +/- into joint if subscapularis torn)
-
ankle
- peroneal tendons (lateral or medial)
- tibialis posterior (medial and anterior)
-<p>A number of processes can affect tendons.</p><h5>Tears and myxoid degeneration</h5><p>Tears are common and are categorised as:</p><ul>- +<p>A number of processes can affect tendons.</p><h5>Tendinopathy (tendonopathy)</h5><p>Literally means a disease or disorder of a tendon and typically used to describe <em>any</em> problem involving a tendon. While many define tendinopathy as an umbrella term to describe all tendon pathology, others may use it to describe a chronic tendon condition that fails to resolve. </p><h5>Tears and myxoid degeneration</h5><p>Tears are common and are categorised as:</p><ul>
-</ul><p>The MRI characteristics are of change in shape of the tendon (thickened, thinned) as well as increase in signal on both T1WI and T2WI. Unfortunately these features are indistinguishable from myxoid degeneration.</p><p>The term <a href="/articles/tendinopathy">tendinopathy</a> is therefore preferred. (NOT <a href="/articles/tendinitis">tendinitis</a> as no inflammatory component is usually present).</p><p>Prediposing factors to tendon rupture</p><ul>- +</ul><p>The MRI characteristics are of change in shape of the tendon (thickened, thinned) as well as increase in signal on both T1WI and T2WI. Unfortunately these features are indistinguishable from myxoid degeneration.</p><p>Prediposing factors to tendon rupture</p><ul>
-</ul><h5>Tenosynovitis</h5><p>Should only be called if fluid is seen surrounding the entire tendon. A <a href="/articles/mesotendon">mesotendon</a> may be seen as a thin low intensity band. If the tendon communicates with a joint, such as the long head of biceps at the shoulder, and flexor hallucis longus at the ankle, then no fluid should be present in the joint to make the call.</p><p>If the fluid is loculated the term <a href="/articles/stenosing-tenosynovitis">stenosing tenosynovitis</a> can be applied. This is most commonly seen in</p><ul>- +</ul><h5>Tendinitis</h5><p>Use to describe situations where there is inflammation of the tendon.</p><h5>Tendinosis</h5><p>Usually implies a non-inflammatory degeneration of a tendon. This degeneration can include changes to the structure or composition of the tendon. </p><h5>Tenosynovitis</h5><p>Should only be called if fluid is seen surrounding the entire tendon. A <a href="/articles/mesotendon">mesotendon</a> may be seen as a thin low intensity band. If the tendon communicates with a joint, such as the long head of biceps at the shoulder, and flexor hallucis longus at the ankle, then no fluid should be present in the joint to make the call.</p><p>If the fluid is loculated the term <a href="/articles/stenosing-tenosynovitis">stenosing tenosynovitis</a> can be applied. This is most commonly seen in</p><ul>
References changed:
- 1. Fredberg U. Tendinopathy--tendinitis or tendinosis? The question is still open. (2004) Scandinavian journal of medicine & science in sports. 14 (4): 270-2. <a href="https://doi.org/10.1111/j.1600-0838.2004.404_3.x">doi:10.1111/j.1600-0838.2004.404_3.x</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/15265151">Pubmed</a> <span class="ref_v4"></span>
Unable to process the form. Check for errors and try again.