Tendinopathy Flashcards
List 3 types of tendinopathy.
Tendinitis
Tendinosis (degenerative)
Tenosynovitis
What is tennis elbow?
What is golfer’s elbow?
Tennis elbow = lateral epicondylitis
Golfer’s elbow = medial epicondylitis
Describe the clinical features of tendinopathy. (6)
Depend on location of tendon Pain Swelling Thickening Tenderness Positive provocative pain tests
List 5 risk factors for tendinopathy.
Age Chronic disease, e.g. diabetes, RA Adverse biomechanics Repetitive activities Quinolone antibiotics
Describe the pathophysiology of tendinopathy. (3)
- Chronic overuse injuries occur due to repetitive micro-traumas
a. Causes tendon degeneration
b. Causes disorganisation of collagen fibres
c. Inflammatory cell infiltration - As the tendon tries to repair damage, collagen becomes more disorganised
a. Causes structural weakness - Increased vascularity around the tendon causes inflammation
a. Mediators: IL1, NO, PGs
b. Stimulates MMPs
c. Apoptosis of tendon cells
d. Pain
What 4 investigations would you do for tendinopathy?
Provocative pain tests
X-ray
Ultrasound
MRI
What features of tendinopathy can be seen on x-ray? (1)
Calcification
What features of tendinopathy can be seen on ultrasound? (4)
Collagen fibre disorganisation
Swelling
Rupture
Increased vascularity
What features of tendinopathy can be seen on MRI? (2)
Swelling
Structural abnormalities
How would you manage tendinopathy? (3)
Lifestyle changes
Medical treatment
Surgical treatment
Which lifestyle changes would you recommend in tendinopathy? (2)
Activity modification
Physiotherapy, e.g.
-Stretching
-Eccentric exercises
What medical treatment can be used for tendinopathy? (6)
GTN patches Platelet rich plasma infection Prolotherapy Extracorporeal shockwave therapy Topaz (radiotherapy ablation) Steroid injection
What is prolotherapy?
Injection of irritant (e.g. dextrose) into tendons
This stimulates healing
Which surgical treatments can be used for tendinopathy? (2)
Debridement
Tendon transfer
