Tendonitis: Difference between revisions
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==Evaluation== | ==Evaluation== | ||
=== | ===Physical Exam=== | ||
''Exam techniques vary based on specific tendinopathy'' | |||
* [[Lateral epicondylitis]] | |||
* [[Medial epicondylitis]] | |||
* [[Patellar tendonitis]] | |||
* [[De Quervain tenosynovitis]] | |||
* Rotator cuff tendinitis | |||
* Bicipital tendinopathy | |||
* Popliteus tendinopathy | |||
* Iliotibial band syndrome | |||
* Medial tibial stress syndrome ("shin splints") | |||
=== | |||
===Labs=== | |||
* Consider labs if concern for infection: | |||
**CBC | |||
**CRP/ESR | |||
===Imaging=== | |||
*Ultrasound | |||
**May aid the diagnosis | |||
**Findings include tendon disruption, increased blood flow, hypoechoic areas, or tendon thickening | |||
*X-Ray | |||
**Consider if concern for fracture, foreign body, or avulsion injury | |||
*MRI | |||
**Not frequently used in ED; may be used by specialist or in outpatient setting | |||
==Management== | ==Management== | ||
Revision as of 15:48, 26 June 2021
Background
- Tendonitis (aka tendinitis) is an inflammation or irritation of a tendon
- Commonly occurs in athletes or middle-aged (or older) patients
- Associated with excessive strain, repetitive trauma, or unaccustomed exercise
- Fluoroquinolone antibiotics and statins may increase risk for tendinopathy[1]
Clinical Features
- Pain w/ movement, particularly at the insertion site.
- Mild swelling
Differential Diagnosis
- Muscle contusion
- Ligamentous Injury
- Nerve compression
- Tumor
- Bursitis
- Osteomyelitis
- Compartment syndrome
- Rhabdomyolysis
- Fracture
- Arthritis
- Myositis
Evaluation
Physical Exam
Exam techniques vary based on specific tendinopathy
- Lateral epicondylitis
- Medial epicondylitis
- Patellar tendonitis
- De Quervain tenosynovitis
- Rotator cuff tendinitis
- Bicipital tendinopathy
- Popliteus tendinopathy
- Iliotibial band syndrome
- Medial tibial stress syndrome ("shin splints")
Labs
- Consider labs if concern for infection:
- CBC
- CRP/ESR
Imaging
- Ultrasound
- May aid the diagnosis
- Findings include tendon disruption, increased blood flow, hypoechoic areas, or tendon thickening
- X-Ray
- Consider if concern for fracture, foreign body, or avulsion injury
- MRI
- Not frequently used in ED; may be used by specialist or in outpatient setting
Management
Disposition
- Most patients with tendinopathy can be discharged safely from the ED
- Admit patients who may benefit from hospitalization or surgery (infection, associated fracture, tendon rupture)
See Also
External Links
References
- ↑ Marie I, Delafenêtre H, Massy N, Thuillez C, Noblet C; Network of the French Pharmacovigilance Centers. Tendinous disorders attributed to statins: a study on ninety-six spontaneous reports in the period 1990-2005 and review of the literature. Arthritis Rheum. 2008;59(3):367-372. doi:10.1002/art.23309