MRI diagnosis of tendinitis of the patellar tendon. Knee tendonitis symptoms and treatment. Side leg raise

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When conducting laboratory tests, no changes are observed, except in cases where the disease is associated with infection or a rheumatoid process.

As a result of constant stress, including frequent impact on the surface of the lower extremities (when running), tendinitis can develop in the upper thigh. It affects the rectus femoris tendon (basis and quadriceps tendonitis), the iliopsoas tendon (hip flexor tendonitis), and the adductor longus tendon (groin tendonitis). The main manifestations of hip tendonitis are:

• changes in gait and lameness;
• slow increase in symptoms;
• pain decreases after initial activity and returns with greater force during subsequent activities;
• cracking in the upper thigh.

Gluteal tendinitis

Tibialis posterior tendinitis

Shockwave therapy for calcific tendonitis of the shoulder - video

Many people experience inflammation of the tendon that connects the tibia and the patella. This indicates tendonitis of the patellar tendon. A person feels stiffness when bending and straightening the leg. It will be difficult to play football, ride a bike or just walk. You can get rid of the disease through timely detection and taking effective measures.

Concept

Patellar tendonitis - what is it? This is a common illness among athletes. It is more often observed in sports where you need to run and jump, as they place an eccentric load on the patellar ligament.

In the onset of the disease, not only the type of sport matters, but also the person’s age. Chronic tendonitis occurs due to a variety of causes, including overuse syndrome, repeated minor injuries, secondary sprains, age-related changes, and poor circulation.

According to the international classification of diseases ICD-10, tendonitis of the patellar tendon is coded M76.5. Designations are used in the medical field all over the world. The ICD-10 code for patellar tendonitis is used to complete documentation.

Causes

Doctors consider injuries and age to be the main factor in the development of tendinitis of the patellar tendon. with regular microtraumas, which usually happens in athletes and people engaged in complex physical labor that puts stress on the knees. Due to sprains, bruises, and dislocations, inflammation appears on the leg, which leads to tendonitis of the patellar tendon.

Deformation and destruction of the patellar ligament occur over time. With age, the body becomes weak and unable to eliminate inflammation on its own. The appearance of tendon disease with weak immunity occurs in pregnant women.

Signs

The disease can be identified using pronounced symptoms. Tendinitis of the patellar tendon manifests itself as pain in the knee area, which usually increases as the load on the legs increases. In order not to confuse the symptoms with the manifestation of other diseases, you need to know how the leg hurts when the front or back is damaged

Discomfort is felt when bending and straightening the leg. Movements to straighten the lower leg will be painful in the evening at the 1st stage of the disease, this disappears after rest. When ligament degeneration develops, the pain becomes intensified and is permanent. During a chronic type of disease, it is difficult to flex and extend the knee. With this disease, the temperature does not rise. Redness and slight swelling may occur in the area of ​​tendon inflammation.

Degrees

There are 4 stages in the development of the disease:

1. Pain occurs only after heavy exertion.
2. Dull pain in the form of attacks appears in the case of standard and light loads after training or physical work.
3. Intense pain also occurs during the rest period.
4. The progression of the pathology causes rupture of the patellar ligaments.

Diagnostics

The presence of tendinitis of the patellar tendon is determined after examining the knee and palpating the medial and lateral ligaments. If the diagnosis is in doubt, hardware diagnostics are used - MRI and radiography.

It is advisable to take a blood test to detect inflammation. Self-diagnosis is often erroneous and can aggravate the disease, so at the first symptoms it is advisable to consult a doctor without delay.

Treatment methods

The stage of the disease affects treatment. Symptoms of tendonitis of the patellar tendon can be eliminated with surgery, but this is performed in extreme cases. It is carried out only when the disease has become chronic, when there is a risk of disability. Conservative methods are used in the initial stages of the disease; they involve a combination of medications with physiotherapy and gymnastics.

Conservative method

Treatment of tendinitis of the patellar ligaments in the traditional way is performed without the use of heavy medications. It is effective in the initial stages of the disease, when degenerative processes are still considered reversible.

You can get rid of microtraumas of the cruciate ligament with the help of rest and the use of special supports - tape tapes and elastic bandages. Deep heating and tissue restoration is performed using ointments with comfrey and mineral mud. At an advanced stage, a specialist prescribes UHF and electrophoresis of the knee, magnetic therapy. When identifying an illness at any stage, excluding chronic, you must adhere to the following rules:

• reduce the load on the knee, reduce the intensity of training;
• apply dry ice compresses to relieve pain and swelling;
• use anti-inflammatory ointments, tablets that restore immunity;
• perform physical therapy exercises, do yoga, Pilates;
• wear supporting knee pads, bandages, and use ligament taping.

Surgery

Surgical intervention is performed either in a conventional, open way or with an arthroscope. Therapy involves removing damaged tissue at the head of the patella. The doctor chooses the method of surgical intervention based on the area and nature of the degenerative processes in the ligaments. Osteophytes are removed arthroscopically, but if there is a cyst in the kneecap, the classic open surgical method is used.

After the operation, you must remain calm and undergo rehabilitation, which consists of therapeutic exercises to develop the knee, physiotherapy, and the use of medications. Recovery lasts 1-3 months. During this period, the leg should have additional support in the form of a knee brace or taping. You need to walk with the support of a cane.

Other methods

Popular methods of therapy include sanatorium-resort treatment. It involves mud and balneological treatment. Azov and Black Sea estuary muds, radon and hydrogen sulfide baths are effective.

At home, laser-ion and vibroacoustic devices are used, for example, Vitafon. Microtraumas can be cured with the help of ointments and gels for athletes, which eliminate muscle spasms and provide nutrition to joints and tendons.

ethnoscience

Some people choose traditional treatment. For tendonitis, prescriptions will not eliminate the cause, but will help alleviate the condition, especially at the initial stage. But before using traditional medicine, you need to consult a doctor.

Various tinctures and herbal teas are used at home. For oral administration, you need to use an infusion of walnut partitions. But this product is prepared in advance, as it is infused for 18 days. Because of this, it is rarely used for acute tendinitis. And for the chronic form, take vodka tincture, 1 tbsp. l. 3 times a day. The product should not be used by car drivers.

Tea made from dried bird cherry berries is also offered. This drink is presented in the form of a decoction, prepared in a water bath. For 1 glass of boiling water you should take 1 tbsp. l. berries When treating an illness, you should use more turmeric seasoning, as its main component relieves pain and inflammation.

Treatment can also be performed using aloe juice compresses. It is obtained from cut leaves of the plant, which must lie in the refrigerator for 24 hours. On the 1st day after injury, 5-6 procedures should be performed, and then 1 time at night.

Using a nourishing cream, make an ointment with arnica. This relieves inflammation and relieves swelling. The cream should be applied 3 times a day. The pharmacy has ready-made ointments with this plant. An excellent result is ensured by lotions based on crushed ginger root (add 2 cups of boiling water to 2 tablespoons of raw material). Infusion is carried out for 30 minutes. Lotions should be performed 3 times a day for 10 minutes.

Compresses and contrast procedures are effective, but they can only be used in the absence of redness of the skin and increased body temperature over the affected joint. These procedures consist of alternating a light massage of ice cubes with heating using wheat grits heated in a frying pan (it is poured into a linen bag or sock). Such sessions improve blood circulation and restore tissue.

Prevention

To prevent tendonitis, you should not allow overload on the knee joint and ligaments. Bruises, dislocations or sprains must be treated to the end; you should not stop therapy after the pain is eliminated, otherwise the inflammation will remain deep in the tissues. As a preventive measure, a bath is used; you can take baths with eucalyptus, salt and apply mud.

Physical activity should be increased and decreased gradually. Before physical exercise, you need to warm up your joints and ligaments. It is important to choose suitable places for sports and effective training methods. Equally important is the correct mode of work and rest. The load on all joints should be harmonious. Thanks to prevention, the risk of developing knee diseases is reduced.

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The knee joint is the largest joint in the human body; it performs the most important supporting function and undergoes enormous loads. The knee is strengthened by large muscles and ligaments that ensure normal joint function, but they can become injured and become inflamed. The consequence of these injuries may be tendinitis of the knee ligament.

Ligament tendonitis: main types

Tendinitis of the knee ligament is an inflammatory disease that seriously affects the patient’s quality of life. The pathology causes pain and does not allow normal movement, and can even cause severe complications in the joint. Therefore, it is very important to consult a doctor at the first symptoms of tendinitis and begin treatment.

Anterior cruciate ligament tendinitis

The knee joint has a rather complex structure; it contains 5 large ligaments that run in and around the joint cavity. These are the lateral, cruciate ligaments and the patellar ligament; they prevent displacement of the joint and limit its movement.

The cruciate ligaments are located in the joint cavity, there are two of them. Anterior cruciate ligament tendonitis usually occurs as a result of a severe injury to the knee when very heavy loads are placed on it. This pathology is typical for athletes and people who carry very heavy objects.

With cruciate ligament tendonitis, pain usually only bothers you during heavy physical activity; during periods of rest or low activity, the discomfort completely disappears. If tendonitis of the ligament is not treated, the disease will lead to its rupture, and then the function of the joint will be completely impaired.

Collateral ligament tendinitis

The lateral ligaments are well developed, they keep the knee from moving to the sides; there are two of them in the knee joint: external and internal. The lateral collateral ligament holds the lower leg in a normal position when the leg is bent, the ligament is relaxed, and when extended it stretches and holds the knees.

Collateral ligament tendonitis can occur for various reasons, most often due to increased physical activity or knee injury. Some negative factors can also increase the risk of disease:

• age-related changes;
• joint instability;
• foot deformity;
• inflammatory and degenerative joint diseases;
• endocrine disorders.

Often the pathology occurs in older people; this is associated with degenerative disorders in the joint. In simple words, ligaments and cartilage gradually wear out, blood circulation and tissue nutrition deteriorate with age, they recover poorly and are easily injured.

Tendonitis of the lateral ligament of the knee

Tendinitis of the medial collateral ligament occurs most often after a sprain, for example, during active sports. When sprained, microtraumas occur in the ligament, and if you do not receive proper treatment, it can easily become inflamed during any physical activity or after hypothermia.

Tendinitis of the lateral collateral ligament is accompanied by pain during movement, swelling around the affected area, redness of the skin and increased local temperature. In the chronic form of tendonitis, the symptoms are less pronounced, but if the ligament ruptures, the pain increases sharply.

Tendinitis of the medial collateral ligament of the knee joint

Tendenitis of the internal collateral ligament is less common than inflammation of the external ligament, but still this pathology remains a fairly common problem among athletes. Regardless of which ligament was affected, you need to see a doctor as soon as possible.

Patients need to understand that tendonitis can be easily treated with conservative methods as long as the ligament does not rupture due to degenerative disorders during inflammation. If this happens, the function of the knee can only be restored through surgery, and such treatment requires more time.

Tendinitis of the medial and lateral ligaments, as well as inflammation of the cruciate ligament, is treated with anti-inflammatory drugs and immobilization. The knee must be given time to recover, so movement in it is limited with the help of an orthosis or a fixing bandage.

After the acute condition is relieved, therapeutic exercises are prescribed to develop the joint and return normal motor activity to the knee. Timely treatment of patellar tendonitis guarantees complete restoration of its function.

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Knee tendonitis– inflammation and degeneration of the tendons located in the knee area. The main cause of tendinitis is constant overstrain and microtrauma of the tendons. This pathology is often detected in athletes. It manifests itself as pain (at first only during active exercise, then at rest), sometimes hyperemia, local swelling and limitation of movements are detected. The diagnosis is made based on complaints, medical history, clinical symptoms, MRI and ultrasound. To exclude other diseases, radiography is prescribed. Treatment is usually conservative.

Knee tendinitis is an inflammatory and degenerative process in the tendon area of ​​the knee joint. The disease, as a rule, affects the patellar ligament itself (“jumper’s knee”), the source of inflammation is usually localized in the area of ​​attachment of the tendon to the bone, although it can occur in any other part of the tendon. It is detected in athletes and is often considered as an occupational disease of volleyball players, basketball players, tennis players, football players and track and field athletes. According to researchers in the field of sports medicine and traumatology, the disease develops more often in men with greater weight.

The provoking factor is constant jumping on hard surfaces. Predisposing factors include an ill-conceived training regimen, wearing uncomfortable shoes, joint injuries, prolonged use of antibiotics, foot pathology (flat feet, hallux valgus), poor posture and pathological changes in the spine (usually acquired). In some cases, secondary tendonitis develops with rheumatic and infectious diseases, endocrine diseases and metabolic disorders. Treatment of knee tendonitis is carried out by orthopedists and traumatologists.

Symptoms of knee tendinitis

There are four clinical stages of tendinitis. In the first stage, pain in the tendon area occurs only at the peak of intense physical activity. At rest and during normal exercise (including during normal training), there is no pain. At the second stage, dull, sometimes paroxysmal pain and discomfort appear with standard loads and persist for some time after training. At the third stage, the pain syndrome intensifies even more, discomfort and pain do not disappear even after 4-8 hours of complete rest. At the fourth stage, due to extensive degenerative changes, the tendon becomes less strong, tears appear in its tissue, and a complete rupture is possible.

Along with the pain syndrome that occurs during exercise and then at rest, a characteristic sign of tendonitis is pain upon palpation and pressure on the tendon. With “jumper’s knee,” pain may occur when you feel the tibial tuberosity and press on the patella. In some cases, slight local swelling and hyperemia of the affected area is detected. There may be a slight restriction of movement.

Diagnosis and treatment of knee tendonitis

The diagnosis is made on the basis of anamnesis, characteristic clinical manifestations and instrumental research data. Changes in blood and urine tests are detected only with secondary symptomatic tendinitis. In the presence of infection, signs of inflammation are detected in the blood; in rheumatic diseases, anticirulin antibodies and rheumatoid factor are determined; in metabolic disorders, the level of creatinine and uric acid increases.

CT of the knee joint, MRI and ultrasound of the knee joint are informative only in the presence of pronounced pathological changes. A violation of the structure, foci of degeneration and tears in the tendon tissue are revealed. X-rays of the knee joint are usually unchanged, sometimes a slight thickening of the soft tissues is visible on the images. Tendinitis is differentiated from traumatic, rheumatic and degenerative lesions of the knee joint; in the process of differential diagnosis, X-ray data are decisive.

Treatment for tendinitis is usually conservative. Stop training completely and carry out complex therapy. Patients are advised to rest and, if necessary, immobilize with a plaster or plastic splint. Analgesics and anti-inflammatory drugs (naproxen, ibuprofen) are prescribed. After eliminating the symptoms of acute inflammation, patients are referred to exercise therapy, massage, electrophoresis with novocaine, iontophoresis, UHF and magnetic therapy. In case of severe swelling, intense pain and fibrotic changes in the tendon, radiotherapy is sometimes used or blockades with corticosteroid drugs are performed.

The load on the joint should be increased smoothly, gradually. During the period of remission, patients are advised to unload the affected ligament using special tapes (tapes) or fixing the knee joint with an orthosis. In some cases, good results are achieved by targeted work with the technique and height of jumps (tendonitis has been found to develop more often in athletes who use a rigid landing strategy, make higher jumps and land with a deeper squat).

Indications for surgical intervention are tears and ruptures of the tendon, as well as the lack of a positive effect from conservative therapy for 1.5-3 months. The operation is performed as planned in an orthopedic or traumatology department. The skin over the affected area is dissected, the ligamentous canal is opened, and pathologically altered tissue is removed. Sometimes, to stimulate the recovery process, they resort to curettage of the lower part of the patella. For large tears and ruptures, surgical reconstruction of the patellar ligament is performed. In the postoperative period, antibiotics, analgesics, exercise therapy, physiotherapeutic procedures and massage are prescribed. You are allowed to start training only after completing rehabilitation measures.

Knee tendonitis is an inflammation that occurs in a tendon or joint, causing external redness or swelling. This condition may cause pain or weakness in the affected area.

The development of the disease can be observed at any age. But mostly people over the age of 40 suffer, as well as those who engage in physical activity or stay in one position for a long time.

With chronic overload, the first reaction is swelling of the tendon, accompanied by microscopic breakdown of collagen and changes in the mucous membrane near the inflammatory area.

Mostly, the area of ​​inflammation occurs at the joints of bones and ligaments, but sometimes the process spreads throughout the tendon. Chronic tendonitis can develop as a result of regular weeds.

For what reasons does the disease develop?

There are many causes of knee tendinitis, the main ones being:

Infection with bacteria and fungi;

Long-term stress on the knee joints;

Numerous microtraumas and damages;

Joint diseases such as rheumatoid arthritis, arthrosis deformans or gout;

Incorrect posture and body structure (presence of flat feet, etc.);

Allergy when taking certain medications;

Wearing uncomfortable shoes;

High mobility and instability of the knee;

Tendon changes that occur with age;

Muscle imbalance.

Based on the cause of the disease, infectious and non-infectious tendinitis are distinguished.

Determining the specific cause of the disease is a major factor in proper treatment, which can lead to prompt recovery.

The main symptom of the disease is limited movement and pain that occurs in and around the area of ​​inflammation, associated with intensity and mobility.

The pain may appear suddenly, but often it increases in accordance with the inflammatory process. There is also high sensitivity when palpating the inflamed tendon.

Symptoms of knee tendonitis include the appearance of a creaking sound, which occurs when the limb moves. Also over the tendon redness or hyperthermia may occur.

There are temporary manifestations of pain as a result of palpation or movement, which are localized in the damaged area.

Complications of knee tendinitis can occur when calcium accumulates, as this causes weakening of the tendon and joint capsule.

Patients experience difficulty going up or down stairs, running, and walking.

Tendonitis develops sequentially, so the following stages of its manifestation are distinguished:

The appearance of pain after significant exertion;

The occurrence of paroxysmal pain during low and standard loads after classes and work activities;

The manifestation of intense pain even when resting;

The patellar ligaments may rupture due to the progression and advanced form of the disease.

Carrying out diagnostic studies

At the initial stage of diagnosing tendonitis, the affected area is examined by palpation. It is very important to correctly differentiate tendonitis from other pathologies.

To clarify the diagnosis, the following examination may be prescribed:

The doctor observes changes that may occur due to infection or rheumatoid arthritis;

Computer and magnetic resonance imaging helps to identify ruptures and changes in tendons that require surgical intervention;

The result of an X-ray examination determines the last stage of the disease, the cause of which was excess salts, as well as arthritis or bursitis;

They can be used to determine changes or narrowing of the structure of the patellar tendon.

An appropriate examination determines the symptoms and stage of the existing knee joint disease, identifying the damaged area and inflammation.

Laboratory research involves the analysis of biological materials from the patient. This includes a blood test.

In this case, leukocytosis, increased uric acid volume, and the presence of C-reactive protein may be detected. In addition, a study of the joint fluid can be done (to detect gout).

Treatment and restoration of the knee joint

Currently, there are the following treatment methods for determining knee tendonitis:

Physical culture of a therapeutic nature;

Traditional medicine methods;

To treat stage 1-3 tendonitis, conservative methods are used.

First of all, the load on the affected joint is limited or it is immobilized.

To reduce the load on the damaged patella, crutches or a cane are used, and immobilization measures include the application of a plaster cast or splint.

A complex of medications and physiotherapy is also used.

If the disease progresses unfavorably, surgical therapy is prescribed.

To reduce the load on the patella, an orthosis or taping is used (attaching special tapes or tapes to the damaged knee).

Orthoses are an effective way to treat knee tendonitis and can be recommended as a preventive measure during training or fitness.

Drug therapy

The drugs eliminate the process of inflammation and pain, but do not lead to complete recovery. Doctors prescribe medications in the form of external agents (creams, ointments, gels) and internal injections.

Long-term use of nonsteroidal drugs can negatively affect the gastric mucosa, which is why they are prescribed for only 2 weeks. If such drugs are ineffective, injections of corticosteroids and platelet-rich plasma are recommended. Corticosteroids relieve pain, but overuse can weaken the tendons.

For severe inflammation of infectious tendinitis, antibiotics and antibacterial agents are recommended.

Physiotherapy

The following physiotherapeutic methods have a positive effect in the treatment of tendinitis:

A therapeutic and physical set of exercises may be prescribed to stretch and strengthen the knee muscles, after which the tendons are restored.

Physiotherapy

Of particular importance in therapy and preventive measures for stage 1 and 2 tendinitis is physical therapy designed to stimulate and stretch the 4-head muscles (quadriceps).

The duration of treatment can be several months, after which you can begin training and exercise.

Therapeutic exercise consists of the following manipulations:

4-head muscle stretch;

Stretching the hamstring muscles;

Raising the legs to the side in a lying lateral position;

Knee extension against resistance;

Raising a straight leg while lying on your back;

Raising your legs to the side while in a lateral position;

Squeezing the ball with your knees, while your back should be pressed against the wall;

Walking or swinging your leg against resistance;

Isometric muscle resistance, knee flexion in a sitting position.

Carrying out the operation

In case of partial tear or complete rupture of the knee tendon at the 4th stage of tendinitis, surgery is prescribed. In this case, the affected tissue in the area of ​​the patella is removed using open (with a regular incision) or arthroscopic (endoscopic surgery) surgery.

If a bone growth appears on the patella with pinching of the ligaments, it is removed arthroscopically (through tiny incisions).

Existing cysts and other degenerative changes on the ligaments are removed openly.

In some cases, along with excision of the altered tissue, the lower zone of the patella is scraped, which helps to activate inflammation.

In the later stages, the ligament is reconstructed to restore the functions of the 4th femoris muscle.

According to many experts, it becomes mandatory to reduce the lower pole of the patella.

During surgery, the Hoffa fat pad can be completely or partially removed and transferred to the area where the ligament attaches.

The postoperative period lasts 2-3 months.

Traditional treatment

This therapy eliminates pain and inflammation under external and internal influences.

The simplest method is rubbing with pieces of ice, using Turmeric seasoning, drinking tincture of walnut partitions, heating with wheat cereal, etc.

Compresses made from infusion of garlic, eucalyptus oil, apple cider vinegar, and grated potatoes can be used.

In the first hours after injury, cold is used in the form of ice or lotions. At the same time, the capillaries narrow, blood supply and swelling decrease.

Knee immobilization

In successful treatment, immobilization of the limb, which limits joint mobility, is considered an important criterion. This allows you to avoid stretching the sore tendon.

In case of active inflammation, a plaster cast may be applied for 2-4 weeks.

Preventive actions

First of all, you need to remember that before physical activity you need to do a warm-up. You should also gradually increase the pace of exercise and not work to the point of overexertion.

If you have minor pain, you should change your activity or rest.

To prevent the disease, you should not do monotonous work with one joint for a long time.

Tendonitis refers to pathologies that reduce a person’s quality of life due to limited movement.

Therefore, along with treatment, prevention should be carried out to reduce the possibility of recurrence of the disease. To do this, the muscles located near the affected tendon are strengthened.

Description and features

The name "tendinitis" has Latin roots, and means "tendon" and "inflammation." Inflammation of the tendons of the knee joint can be localized in the kneecap and surrounding tissues, at the site of attachment of the tendon to the bone.

The disease is characterized by inflammation of the patellar tendon, which attaches to the tibia and is a continuation of the quadriceps tendon. Both adults and children are included in the so-called risk zone, but most often they suffer from the disease:

1. Athletes. It should be noted right away that athletes are divided into two large groups. Some people go in for sports for the sake of health, without causing harm and unnecessary stress on the body through physical training. Others are professionals who are ready to sacrifice their health for the sake of records and sporting achievements. The result is endless injuries and loss of motor activity.
2. People leading a sedentary lifestyle. In the absence of even minimal loads, slow degradation of tendon muscle tissue occurs. Subsequently, minor physical stress becomes the cause for the development of knee tendinitis.
3. People who, due to their professional activities, must constantly engage in heavy physical labor. Their ligaments and joints wear out prematurely, and as a result, tendonitis can develop as an occupational disease.
4. Children often fall, but not all injuries go unnoticed. In adulthood, knee injuries sustained in childhood can remind themselves in the form of similar inflammation.

Video “Treatment of knee tendinitis”

In this video, an expert will tell you how to effectively treat knee tendinitis.

Patellar tendonitis can occur for many reasons:

• injuries;
• concomitant diseases (arthritis, arthrosis);
• constant excessive load on the joint;
• infections;
• pathology (flat feet, lameness);
• wearing narrow, uncomfortable shoes and constantly walking in heels;
• weakened immune system;
• age-related tendon degeneration;
• spinal deformity;
• excess weight.

Considering the cause of a particular case of inflammation, the doctor can determine whether the tendinitis is infectious or non-infectious.

A separate type is considered to be calcific tendinitis, in which calcium salts are deposited at the site of the inflammatory process in the tendon. However, the causes of this type of tendinitis are not fully understood.

Signs and symptoms

There are main characteristic signs of knee tendinitis:

• unpleasant discomfort in the knee area begins to limit movements, during which a slight creaking sound is heard;
• the knee becomes swollen, red, hot and painful to the touch;
• attempts at sudden movements of the knee cause an attack of acute shooting pain.

With further development of the disease, the following signs may appear:

• attacks of pain that are not associated with exercise;
• the patient suffers from pain even during rest;
• partial or complete rupture of tendons and ligaments may occur, which is often observed in advanced forms of the disease.

The occurrence of these symptoms should increase the patient's attention, and it should be recalled that at the first such signs one should consult a doctor.

Another common type of tendonitis of the knee joint is the lesion of the “crow's foot” - this is the name of the place where the muscle tendons attach to the back of the thigh to the tibia. The pathological process is localized along the medial (inner) surface of the knee and consists of inflammation of the collateral ligaments of the joint. Typically, this pathology is observed in professional athletes.

Degrees of development

The classification of patellar tendinitis distinguishes 4 stages of development, each of which is endowed with certain symptoms:

1. In the first stage of development, the patient complains of pain only when the knee is subjected to physical stress, for example, during sudden lifting of a weight, during a long climb up the stairs, or squats.
2. On the second, the attacks of pain intensify and cause discomfort even in the absence of stress.
3. In the third stage, the pain torments the patient more and more often and persistently, and does not disappear even with complete rest.
4. In the fourth stage, degenerative changes in the tendons form microcracks, which can lead to rupture of tendon tissue. There is a significant limitation of movements.

Diagnostics

The diagnosis of the disease is carried out by a traumatologist. After collecting complaints and medical history of the patient, the doctor begins an objective examination of the patient. Then the doctor prescribes laboratory and instrumental studies. X-rays, ultrasound, CT and MRI are considered the most informative in diagnosing the disease.

Treatment and prevention

Comprehensive treatment of patellar tendinitis includes the following methods:

• medicinal;
• physiotherapy;
• surgical;
• ethnoscience.

Conservative treatment of knee tendinitis concerns the first, second, sometimes and third stages? and is aimed mainly at providing the right or left limb with complete rest; if necessary, the joint is immobilized with a splint.

Drug treatment is aimed at relieving pain and eliminating the inflammation process. Anti-inflammatory non-steroidal drugs and analgesics are prescribed in the form of tablets, injections or ointments for external use. The doctor recommends treating a patient with inflammation of the infectious form of tendinitis by prescribing antibiotics and antibacterial drugs. Physiotherapy will add a good positive effect in combination with taking medications:

For chronic forms of the disease, massage courses are prescribed.

Exercise therapy classes begin only during the period of remission, after several months of treatment. Developing joints is a long, painstaking job that does not require haste. The exercises are carefully selected by the instructor with a special individual approach. Classes begin at a slow pace with smooth, unhurried movements, and the load is added gradually.

In the fourth stage of tendon rupture, surgical intervention is indispensable.

Some preventive measures that will significantly reduce the risk of disease:

• before playing sports, do light exercise to warm up your muscles;
• alternate work with rest;
• To prevent tendon damage, use knee tapes.

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- This is an inflammatory process in the tendon area. It can be acute or chronic. With chronic tendonitis, degenerative processes develop over time in the area of ​​the affected tendon. As a rule, the part adjacent to the bone suffers; less often, inflammation spreads throughout the tendon. The pathology is accompanied by pain during movements, slight swelling, hyperemia and local fever. Treatment can be either conservative or surgical. Prevention of exacerbations is of great importance in chronic tendinitis.

ICD-10

M75.2 M76.7 M76.5 M76.6

General information

Tendonitis is a disease of the tendon. Accompanied by inflammation, and subsequently by degeneration of part of the tendon fibers and adjacent tissues. Tendonitis can be acute or subacute, but is more often chronic. Typically, tendonitis affects the tendons located near the elbow, shoulder, knee and hip joints. The tendons in the ankle and wrist joints may also be affected.

Tendinitis can develop in a person of any gender and age, but is usually observed in athletes and people with monotonous physical labor. The cause of tendinitis is too high loads on the tendon, leading to microtrauma. As you age, your likelihood of developing tendonitis increases due to weakening of ligaments. In this case, calcium salts are often deposited at the site of inflammation, that is, calcific tendinitis develops.

Causes of tendinitis

A high level of physical activity and microtraumas occupy first place among the causes of the development of pathology. Some athletes are at risk: tennis players, golfers, throwers and skiers, as well as people engaged in repetitive physical work: gardeners, carpenters, painters, etc. However, in some cases, tendonitis can also occur for other reasons, for example, due to certain rheumatic diseases and thyroid diseases. Tendinitis can also result from a number of infections (for example, gonorrhea), develop as a result of the action of medications, or due to abnormalities in the structure of the bone skeleton (for example, with different lengths of the lower extremities).

Pathogenesis

A tendon is a dense and strong inelastic cord formed by bundles of collagen fibers that can connect muscle to bone or one bone to another. The purpose of tendons is to transmit movement, ensure its precise trajectory, and also maintain joint stability.

With repeated intense or too frequent movements, the fatigue processes in the tendon prevail over the recovery processes. A so-called fatigue injury occurs. First, the tendon tissue swells and the collagen fibers begin to break down. If the load is maintained, islands of fatty degeneration, tissue necrosis and deposition of calcium salts subsequently form in these places. And the resulting hard calcifications further injure the surrounding tissues.

Symptoms of tendinitis

Tendonitis usually develops gradually. At first, a patient with tendinitis is bothered by short-term pain that occurs only at the peak of physical activity on the corresponding area. The rest of the time there are no unpleasant sensations, the patient with tendonitis maintains his usual level of physical activity. Then the pain syndrome due to tendonitis becomes more pronounced and appears even with relatively light loads. Subsequently, pain due to tendinitis becomes intense and paroxysmal and begins to interfere with normal daily activities.

On examination, redness and a local increase in temperature are detected. Sometimes swelling appears, usually mild. Pain is detected during active movements, while passive movements are painless. Palpation along the tendon is painful. A characteristic sign of tendinitis is a crunching or crackling sound during movement, which can be either loud, easily audible at a distance, or detectable only with the help of a phonendoscope.

Types of tendinitis

Lateral tendinitis

Lateral epicondylitis, also known as lateral tendinitis or tennis elbow, is an inflammation of the tendons that attach to the extensor muscles of the wrist: the extensor carpi brevis and longus, as well as the brachioradialis muscle. Less commonly, lateral tendonitis affects the tendons of other muscles: the extensor carpi ulnaris, extensor radialis longus, and extensor digitorum communis. Lateral tendonitis is one of the most common diseases of the elbow joint in traumatology and orthopedics, occurring in athletes. This form of tendonitis affects about 45% of professionals and about 20% of amateurs, who play on average once a week. The likelihood of developing tendinitis increases after age 40.

A patient with tendonitis complains of pain along the outer surface of the elbow joint, often radiating to the outer part of the forearm and shoulder. Gradually increasing weakness of the hand is noted. Over time, a patient with tendonitis begins to experience difficulties even with simple everyday movements: shaking hands, twisting clothes, lifting a cup. Palpation reveals a clearly localized painful area on the outer surface of the elbow and above the lateral part of the epicondyle. The pain intensifies when trying to straighten the bent middle finger against resistance.

X-rays for tendonitis are not informative, since the changes affect soft tissue structures rather than bones. To clarify the location and nature of tendinitis, magnetic resonance imaging is performed. Treatment for tendinitis depends on the severity of the disease. In case of mild pain, you should avoid putting stress on your elbow. After the complete disappearance of pain, it is recommended to resume the exercise, initially in the most gentle mode. In the absence of unpleasant symptoms, the load is subsequently increased very smoothly and gradually.

For tendinitis with severe pain, short-term immobilization using a light plastic or plaster splint, local non-steroidal anti-inflammatory drugs (ointments and gels), reflexology, physiotherapy (phonophoresis with hydrocortisone, electrophoresis with novocaine solution, etc.), and subsequently - physiotherapy . For tendonitis accompanied by persistent pain and the absence of effect from conservative therapy, blockades with glucocorticosteroid drugs are recommended.

The indication for surgical treatment of tendonitis is the ineffectiveness of conservative therapy for one year with reliable exclusion of other possible causes of pain. There are 4 methods of surgical treatment of lateral tendonitis: Heumann's laxative operation (partial cutting of the extensor tendons in the area of ​​attachment), excision of the altered tendon tissue with its subsequent fixation to the lateral epicondyle, intra-articular removal of the annular ligament and synovial bursa, as well as tendon lengthening.

In the postoperative period, short-term immobilization is recommended. Then the traumatologist prescribes therapeutic exercises to the patient to restore range of motion in the elbow joint and strengthen the muscles.

Medial tendinitis

Medial epicondylitis, also known as pronator and flexor tendonitis, or golfer's elbow, develops when the tendons of the palmaris longus, flexor carpi ulnaris, flexor carpi radialis, and pronator teres tendons become inflamed. Medial tendonitis is detected 7-10 times less often than lateral tendinitis. This disease develops in those who are engaged in light but monotonous physical labor, during which they have to perform repeated rotational movements of the hand. In addition to golfers, medial tendonitis often affects assembly workers, typists and seamstresses. Among athletes, tedninitis is also common in those who play baseball, gymnastics, tennis and table tennis.

The symptoms are similar to lateral tendonitis, but the painful area is on the inside of the elbow joint. When bending the hand and pressing on the area of ​​injury, pain occurs above the inner part of the epicondyle. To confirm tendinitis and assess the nature of the process, magnetic resonance imaging is performed. Conservative treatment is the same as for lateral tendinitis. If conservative therapy is ineffective, a surgical operation is performed - excision of the altered sections of the pronator teres and flexor carpi radialis tendons with their subsequent suturing. After the operation, short-term immobilization is prescribed, and then physical therapy classes.

Patellar tendinitis

Patellar tendinitis, or jumper's knee, is an inflammation of the patellar tendon. Usually develops gradually and is primarily chronic. Caused by short-term, but extremely intense loads on the quadriceps muscle. In the initial stages of knee tendinitis, pain occurs after exercise. Over time, pain begins to appear not only after, but also during physical activity, and then even at rest. When examining a patient suffering from tendonitis, pain is detected when actively extending the leg and when pressing on the area of ​​damage. In severe cases, local swelling may occur. An MRI is prescribed to confirm tendinitis.

Conservative therapy for tendinitis includes avoidance of stress, short-term immobilization, local anti-inflammatory drugs, cold and physical therapy (ultrasound). Blockades for this type of tendinitis are contraindicated, since the administration of glucocorticosteroids can cause weakening of the patellar tendon with its subsequent rupture. The indication for surgical treatment of patellar tendonitis is the ineffectiveness of conservative therapy for 1.5-3 months or mucous degeneration of the tendon identified on MRI. During the operation, the damaged area is excised and the remaining part of the tendon is reconstructed.

The choice of surgical procedure (open - through a regular incision or arthroscopic - through a small puncture) depends on the extent and nature of the pathological changes. If the ligament is pinched due to a bone spur on the patella, arthroscopic surgery is possible. For extensive pathological changes in the tendon tissue, a large incision is necessary. After surgery, a patient with tendonitis is given a plastic or plaster splint. Subsequently, restorative therapeutic exercises are prescribed.