- Daniel J Sexton, MD
Daniel J Sexton, MD
- Editor-in-Chief — Infectious Diseases
- Section Editor — Bacterial Infections
- Professor of Medicine
- Duke University Medical Center
Tenosynovitis refers to inflammation of a tendon and its synovial sheath; this condition occurs most frequently in the hands and wrist but can occur in any joint. Issues related to infectious tenosynovitis will be reviewed here. Noninfectious causes of tenosynovitis can mimic clinical features of infectious tenosynovitis; these disorders are discussed separately. (See "de Quervain tendinopathy" and "Trigger finger (stenosing flexor tenosynovitis)".)
The anatomic placement of tendons, their sheaths, and the adjacent bursae has important implications for the clinical features of tenosynovitis (inflammation of a tendon sheath) (figure 1). (See "Finger and thumb anatomy".)
Extensor and flexor tendon sheaths have two surfaces: an inner visceral layer adherent to the tendon and an outer parietal layer abutting adjacent structures such as bursae and muscles. In their normal states, the visceral and parietal layers abut one another; in the setting of tenosynovitis, the space between the two layers may fill with inflammatory or purulent fluid.
The visceral and parietal layers of most tendons are tightly joined at the ends to produce a closed compartment encased in a tendon sheath. Many tendon sheaths lie in close proximity to adjacent bursae. Therefore, infection in a tendon sheath can spread readily to adjacent bursae as well as other tendon sheaths. For example [1,2]:
●Infectious tenosynovitis involving the extensor tendons on the dorsum of the hand can spread via bursae to the volar surface of the hand.
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