Extensor Tenosynovitis

Four cases of tendinopathy have been reported in three men and one woman taking statins (60). The diagnoses were extensor tenosynovitis in the hands, tenosynovitis of the tibialis anterior tendon, and Achilles tendinopathy. Two patients were taking simvastatin and two atorvastatin. The tendinopathy developed 1-2 months after the start of treatment. The outcome was consistently favorable within 1-2 months after drug withdrawal. 

Radiol Clin North Am 37 669-678 Craig JG, Jacobson JA,Moed BR (1999) Ultrasound of fractures and bone healing. Radiol Clin North Am 37 737-751 Craig JG, van Holsbeeck M, Alva M (2003) Gonococcal arthritis of the shoulder and septic extensor tenosynovitis of the wrist sonographic appearances. J Ultrasound Med 22 221-224... 

Fig.l0.68a-d. Distinguishing joint synovitis versus extensor tenosynovitis with US. a,b Transverse 12-5 MHz US images obtained over the dorsal wrist in two patients with rheumatoid arthritis each presenting with tenderness and swelling over the dorsal right wrist. In a, the synovial effusion (asterisks) is closely apposed to the wrist bones because the inflammatory process involves the dorsal recesses of the wrist joints, whereas the overlying extensor tendons (T) are spared. In b, the effusion (asterisks) occurs all around the extensor tendons (T) as an expression of tenosynovitis, while the dorsal recesses of the wrist joints are normal. c,d Diagram correlations... 

The Musculoskeletal disorders more commonly seen in dental surgeons are Carpal Tunnel Syndrome Ulnar Nerve Entrapment Pronator Syndrome Tendinitis Tenosynovitis Extensor Wad Strain Thoracic Outlet Syndrome Rotator Cuff Tendonitis (Nield-Gehrig, 2008). 

Fig. 10.33 a,b. Schematic drawings illustrate typical sites of overuse tendinopathies in the a dorsal and b ventral wrist, including Ay de Quervain tenosynovitis B, intersection syndrome C,extensor pollicis longus tenosynovitis, ),extensor carpi ulnaris tenosynovitis E, flexor carpi radialis tenosynovitis F, flexor digitorum superficialis and flexor digitorum profundus tenosynovitis Gy flexor carpi ulnaris tendinopathy... 

As already stated, the extensor pollicis longus tendon (third compartment of the extensor tendons) is a thin tendon that reflects over the medial aspert of the Lister tubercle before reaching the dorsum of the hand. Because of mechanical friction and its small size, the extensor poUicis longus is frequently affected by tenosynovitis that presents with local pain over the Lister tubercle and, less commonly, with local crepitus during thumb movements. This condition can be assodated with previous fractures of the distal radius... 

Denman 1979) and leads to considerable tendon weakness, partial and complete tears if untreated. In extensor pollicis longus tenosynovitis, the synovial sheath effusion is typically found just proximal to the Lister tuberde and after the tendon has crossed the extensor carpi radialis longus (Fig. 10.40). Due to the restricted space under the fasda, the synovial sheath of this tendon maybe distended with fluid in the area of the Lister tuberde and over the radial wrist extensors only wflien the amount of effusion is remarkable. 

Fig. 10.41 a,b. Hypertrophic tenosynovitis of the extensor carpi ulnaris in a patient with rheumatoid arthritis, a Short-axis and b long-axis 12-5 MHz US images of the extensor carpi ulnaris tendon (ecu) reveal hypoechoic synovial pannus (arrowheads) which causes abnormal distention of the synovial sheath. The extensor carpi ulnaris is displaced anteriorly because of loosening of the retinaculum. Note the pannus filling the distal radioulnar joint cavity (arrow)... 

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