What is Tenosynovitis of Hand

Host: Do you often see a thing called tenosynovitis involving the arm or the wrist? Guest: Tenosynovitis of the fingers and wrist is quite common, but not as common as trigger fingers. Trigger finger is also tenosynovitis. Host: Well, first of all what do you mean by tenosynovitis, it is a big word and what does it really mean? Guest: So teno- stands for tendon; syno- stands for the synovium, the lining of the tendon; and -itis stands for the inflammation. Host: So where does this come from? Guest: Tenosynovitis can come from two things; one from idiopathic inflammation and second -- Host: Idiopathic mean the does not know why. Guest: And the second, from secondary causes like, rheumatoid arthritis and the third one, I should have said three causes, is from infection. And the most common infectious cause of tenosynovitis in the fingers and the wrist and forearm is tuberculosis. Host: Tuberculosis! Guest: Tuberculosis in Brooklyn and Bronx is the most common cause of infectious tuberculosis. Host: I thought TB was almost eradicated, and you are telling me you are seeing TB. Guest: Yes in several cases of -- Host: Are these people born from the other parts of the world and then came here. Guest: 60% of the patients who have tuberculosis in our country are immigrants from other countries. Host: That’s 60%. Now you get 40%. I mean we are seeing in TB in this country too now? Guest: 40% of the American born people develop tuberculosis, but tuberculosis is not so common now. Host: Are there some viruses that can cause tenosynovitis, maybe just cause inflammation build up. Guest: Patients who have HIV; they have a higher incidence of tenosynovitis and majority of them is tuberculosis. Host: In kids we know it can affect especially the hip joint, and we usually think it is a virus but it goes away by itself, thank god. Guest: Many times, it goes away by itself, but in the hip you have to be careful, make sure that there is no bacterial infection. Host: But it is a very -- Guest: It's a disaster. Host: But your approach, basically, is very conservative of situations like that? Guest: For tenosynovitis of the wrist and the fingers, the basic treatment is to immobilize the joint and if that doesn't work, give a cortisone injection. And if that doesn't work, then take the biopsy to make sure it is not an infection, and perhaps they will tell you for some infection. Host: Thank you very much.