Tendonitis is a topic covered in the 5-Minute Emergency Consult.

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  • The term “tendinitis” has been used to describe chronic painful tendon injuries before the underlying pathology was understood. This term has led to confusion about the cause, chronicity, and treatment of the underlying disorder. The terms “tendinosis” or “tendinopathy” should be used to describe chronic tendon disorders.
  • Overuse syndrome:
    • Clinical syndrome of chronic pain and tendon thickening
    • Synovial cells increase in thickness
    • Excess synovial fluid collection
    • Constant irritation
  • If no further injury occurs, the acute process may last from 48 hr–2 wk.
  • Tendinopathy is described as fibrosis being present without inflammatory cells and symptoms persist longer than 3 mo.


  • Mechanical overload or repetitive microtrauma to the musculotendinous unit:
    • Intrinsic factors:
      • Inflexibility
      • Muscle weakness or imbalance
    • Extrinsic factors:
      • Excessive deviation, frequency, or activity
    • In tendinopathies, the collagen is in a state of disrepair, with proliferation and chronic irritation of neurovascular repair tissue in the tendon and its linings.
  • Chemotactive and vasoactive chemical mediators are released:
    • Vasodilatation and cellular edema increasing the number and activity of PMNs

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