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SEVERE TENDON SWELLING


WHAT YOU SHOULD KNOW

Patients may develop large amounts of swelling around certain tendon groups in the hand and wrist region. The swelling often just keeps slowly getting larger.  The reasons for such swelling are either a special inflammatory condition such as rheumatoid arthritis or a slow growing infection caused by either a fungus or atypical mycobacteria.

MEDICAL HISTORY

Patients may complain of a dull ache or limitation of motion of function in the affected body part. Usually the patient cannot remember any specific event that matches the problem starting.

EXAMINATION

The swollen tissue feels spongy and matches the anatomy of a certain group of tendons. Sometimes, the mass of spongy tissue can be seen to move back and forth when the tendons move.

ADDITIONAL TESTS: In rare cases a Magnetic Resonance Image picture will be taken before surgery. The tissue obtained at the time of surgery is sent to 2 different laboratories: one to make a microscope slide and determine what type of tissue it is, the other is the infection laboratory where cultures will be grown to identify a fungal or atypical mycobacterial species causing infection.

TREATMENT OPTIONS

  NON-OPERATIVE SURGICAL EXCISION
CONSISTS OF Cortisone injection of the swollen tissue Remove all swollen tissue around tendons
FEATURES Designed to limit inflammation Complete excision, outpatient surgery
ADVANTAGES Partially and temporarily effective if due to rheumatoid arthritis Obtains sample for laboratory
DISADVANTAGES No effect if due to infection Laboratory does not always generate a clear answer, recurrence is possible

RECOVERY

Sutures are removed in the office at 2 weeks. The area where the tissue was removed usually becomes quite stiff and needs outpatient rehabilitation exercises under the guidance of a therapist. If the infection laboratory identifies a fungus or atypical mycobacterial species, the patient will need to take antibiotics for many months to kill any remaining microscopic disease too small to be seen at the time of surgery. If the laboratory work does not identify any cause, recurrence becomes more likely. If special arthritis conditions are identified, the patient will consult with a rheumatologist.
 
 
 
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  • I was very impressed with how I was treated by the doctor as well as the Medical assistant. All my questioned were answered and I was treated with care and respect. Luis was Awesome! Doctor Henry was very informative. I will recommend him to friends and family - 06/09/17
  • MD was very thorough and spent a good amount of time with the patient (me). MD had good bedside manners which you do not see from a lot of doctors nowadays. He also made sure everything was understood and that I was given a chance to ask questions or address any concerns I had. Everyone was courteous and professional. Thank you for making mu visit a pleasant one. - 05/02/18
  • I am really happy with my experience. I always knew what was going on and over time got to know the staff based on how many times I've been here. Most importantly, I feel I got the right treatment for my injury. - 10/19/17
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  • every body was excelent - 01/09/18
  • With the severity of my injury I am amazed at how functional my wrist is with the amazing team work shown at the office. From the very start the service and care have been outstanding!! I can't thank everyone enough! - 02/23/18
  • Dr. Mark Henry is a true healer; the finest most competent doctor I've ever encountered. I am forever grateful to Dr. Henry and the entire staff for saving my finger and facilitating my complete recovery with grace and seriousness of intent. Thank you. - 01/10/18
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  • Very nice staff and surgeon. Thumb looks good now after surgery, hopefully thumb continues to heal and stays healed. Thank you - 01/30/18
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  • the whole group was very good, I had an excellent experience. - 11/09/17
  • Dr. Henry was able to salvage my hand to make it usable again. I have already sent my Father here and he no longer has any pain in his wrist. - 11/13/17
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