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Tenossinovite da mão e do punho

  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
Last reviewed: 11 Aug 2025
Last updated: 23 Jul 2024

Summary

Definition

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • localização sobre e ao redor de uma bainha retinacular
  • dor aumentada com movimento
  • resposta à injeção de anestésico
  • sensação de estalido doloroso com a flexão e extensão do dedo (dedo em gatilho)
  • nódulo palpável no nível da cabeça do metacarpo (dedo em gatilho)
  • dor, sensibilidade à palpação e edema localizados no lado radial do punho (doença de De Quervain)
  • dor e edema proximais à articulação do punho (síndrome de intersecção)
  • dor, edema e sensibilidade à palpação no tubérculo de Lister (tenossinovite do extensor longo do polegar)
  • dor no lado ulnar do punho (tenossinovite do extensor ulnar do carpo)
  • dor na prega palmar do punho sobre o tubérculo escafoide e ao longo do comprimento do tendão (tenossinovite do flexor radial do carpo)
Full details

Other diagnostic factors

  • duração dos sintomas por semanas ou meses
Full details

Risk factors

  • idade entre 50 e 60 anos
  • sexo feminino
  • história das atuais afecções concomitantes com patologia semelhante (tendinopatia estenosante ou neuropatia)
  • comprometimento da mão dominante
  • Diabetes mellitus insulinodependente
  • gestação e lactação
  • trauma ou doença articular degenerativa
  • hiperlipidemia
Full details

Diagnostic tests

1st tests to order

  • ultrassonografia de alta resolução
Full details

Tests to consider

  • radiografia simples da mão e punho afetados
  • Hemograma completo
  • Velocidade de hemossedimentação (VHS)
  • proteína C-reativa
  • RNM
  • Tomografia computadorizada (TC)
Full details

Treatment algorithm

ACUTE

dedo em gatilho

doença de De Quervain

tenossinovite do extensor longo do polegar

tenossinovite do tendão extensor ulnar do carpo

todas as outras tenossinovites

Contributors

Authors

Jennifer Moriatis Wolf, MD

Professor

Department of Orthopaedic Surgery and Rehabilitation

University of Chicago Hospitals

Chicago

IL

Disclosures

JMW will join the board of the Journal of Bone and Joint Surgery (American volume) starting October 2024. JMW declares that she is Board Member - Past President of American Society for Surgery of the Hand. Her stock ownership of Unify Medical has ended.

Acknowledgements

Dr Jennifer Moriatis Wolf would like to gratefully acknowledge Dr Doug Campbell, Dr Peter Evans, and Dr Shafic Sraj, the previous contributors to this topic. DC, PE, and SS declare that they have no competing interests.

Peer reviewers

Philip E. Blazar, MD

Assistant Professor of Orthopedic Surgery

Harvard Medical School

Brigham and Women's Hospital

Boston

MA

Disclosures

PEB declares that he has no competing interests.

S. Raja Sabapathy, MS, MCh, DNB, FRCS, MAMS

Director and Head

Department of Plastic, Hand and Reconstructive Microsurgery and Burns

Ganga Hospital

Coimbatore

India

Disclosures

SRS declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

American College of Radiology. ACR-SABI-SPR-SSR practice parameter for the performance of magnetic resonance imaging (MRI) of the wrist. 2022 [internet publication].Full text

American College of Radiology. ACR-SPR-SSR practice parameter for the performance and interpretation of magnetic resonance imaging (MRI) of the fingers and toes. 2023 [internet publication].Full text

American College of Radiology. ACR-SPR-SSR practice parameter for the performance and interpretation of magnetic resonance imaging (MRI) of bone, joint, and soft tissue infections in the extremities. 2021 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Tenossinovite da mão e do punho images

  • Differentials

    • Osteoartrite (para De Quervain, tenossinovite do flexor radial do carpo)
    • Fratura oculta (por exemplo, escafoide)
    • Celulite
    More Differentials

  • Guidelines

    • ACR-SPR-SSR practice parameter for the performance and interpretation of magnetic resonance imaging (MRI) of the fingers and toes
    • ACR-SABI-SPR-SSR practice parameter for the performance of magnetic resonance imaging (MRI) of the wrist
    More Guidelines

  • Patient information

    Osteoartrose: o que é?

    Artrite reumatoide

    More Patient information
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