Tendinitis is a painful inflammation of tendons and of tendon-muscle attachments to bone, especially in the shoulder rotator cuff, Achilles' tendon, or hamstring.
Causes
· Overuse, such as strain during sports activity
· Other musculoskeletal disorder, such as rheumatic diseases, congenital defects
· Postural misalignment
· Abnormal body development
· Hypermobility
Pathophysiology
A tendon is a band of dense fibrous connective tissue that attaches muscle to bone. Tendons are extremely strong, flexible, and inelastic. Tendinitis is an inflammation of the tendon, usually resulting from a strain.
Age Alert
Common forms of tendinitis in adolescents (both males and females) are patellar tendinitis associated with inflammation of the tibial apophysis (Osgood-Schlatter disease) and Achilles' tendinitis at the calcaneal apophysis (Sever's disease).
Signs and symptoms
· Restricted range of motion
· Localized pain (most severe at night; commonly interferes with sleep)
· Swelling
· Crepitus
· Calcific tendinitis
§ Proximal weakness (due to calcium deposits in the tendon)
§ Calcium erosion into adjacent bursae (acute calcific bursitis)
Diagnostic test results
· X-rays may be normal at first but later show bony fragments, osteophyte sclerosis, or calcium deposits.
· Arthrography shows irregularities on the undersurface of the tendon.
· Computed tomography scan and magnetic resonance imaging identify tears, partial tears, and inflammation.
Treatment
· Immobilization with a sling, splint, or cast
· Systemic analgesics
· Application of cold or heat
· Injection of a corticosteroid and an anesthetic such as lidocaine into tendon sheath
· Oral nonsteroidal anti-inflammatory drugs until patient is free of pain and able to perform range-of-motion exercises easily
· Surgical debridement of degenerative tendon or excision of calcific deposits may be needed.
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ELBOW TENDINITIS
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