[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-505922-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-505922-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","tendinopathies-of-the-elbow-wrist-and-hand-histopathology-and-clinical-considerations","Tendinopathies of the Elbow, Wrist, and Hand - Histopathology and Clinical Considerations","","This article reviews current histopathological views of common elbow, wrist, and hand tendinopathies, linking tissue findings to clinical decision-making. It addresses how histopathology can influence examination, diagnosis, prognosis, intervention selection, and expected outcomes. The discussion also highlights acute versus chronic presentations and the limitations of clinical observation alone in distinguishing inflammation from degenerative tendon changes, guiding future research into therapeutic interventions.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/tendinopathies-of-the-elbow-wrist-and-hand-histopathology-and-clinical-considerations/505922/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/tendinopathies-of-the-elbow-wrist-and-hand-histopathology-and-clinical-considerations/505922.png","ImageObject",300,407,{"name":42,"@type":43},"Mafia Boss","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-06","2026-10-04",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",8,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"How does the article distinguish acute from chronic tendinopathy?","Question",{"text":63,"@type":64},"Acute tendinopathy is activity-aggravated pain with an unknown pain source, which may involve inflammation around connective tissues or a symptomatic degenerative tendon. Chronic or long-standing tendinopathy refers to localized activity-induced pain that does not respond to nonoperative treatments.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Why can clinical observation alone be insufficient for tendinopathy?",{"text":68,"@type":64},"Clinical observation cannot determine whether insidious-onset pain is driven by inflammation or represents early symptomatic degeneration. Treatment choices may differ depending on which histopathological process is involved.",{"name":70,"@type":61,"acceptedAnswer":71},"What tendon-structure elements are emphasized in the article?",{"text":72,"@type":64},"The article describes tendons as primarily collagen with ground substance and tenocytes, organized into bundles surrounded by endotenon, epitenon, and peritendon. It also covers wrist and hand fibrous sheaths, pulley systems, fibrocartilage related to gliding, and rich innervation with free nerve endings functioning as pain receptors.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},505922,1791272861,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":111,"show_sort_weight":112,"slug":113},"Research & Report",30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":139,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":145,"preview_page_count":4},962090760730,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","CLINICAL SECTION  \nJHT READ FOR CREDIT ARTICLE \\#224.  \nTendinopathies of the Elbow, Wrist, and Hand: Histopathology and Clinical Considerations  \nJane M. Fedorczyk, PT, PhD, CHT, ATC Department of Physical Therapy & Rehabilitation Sciences, Drexel University, Philadelphia, Pennsylvania  \nABSTRACT: This article reviews the current opinion of the histopathological findings of common elbow, wrist, and hand tendinopathies. Implications for client management including examination, diagnosis, prognosis, intervention, and outcomes are addressed. Concepts for further research regarding common therapeutic interventions are discussed.  \nJ HAND THER. 2012;25:191–201 .  \nTendinopathy is a term used to describe a painful tendon condition without confirmation of histopathological findings. In the worst case scenario, it maybe characterized as a long-standing tendon condition with localized activity-induced pain that fails to respond to nonoperative therapeutic interventions. Conversely, an acute tendinopathy represents a painful tendon condition aggravated by activity, but the source of pain mediation is not known. For example, it may be because of inflammation of the connective tissues that surround the tendon or it may be a symptomatic degenerative tendon, or both. Clinical observation alone cannot determine if pain from atendinopathy of insidious onset is because of inflammation and/or the first sign of a symptomatic degenerative tendon. Chosen treatment options could potentially be quite different if the therapist knew the histopathology involved.  \nAcute tendinopathies or tenosynovitis may develop in hand and wrist tendons as a result of rheumatologic disorders or bacteria infections. The latter is called pyogenic flexor tenosynovitis and it typically occurs from a puncture wound from a rose thorn or fishing hook. Kanavel’s four cardinal signs1 is the typical clinical presentation of acute tenosynovitis of the finger flexor tendons (Box 1) .  \nElbow, wrist, and hand tendinopathies are often associated with repetitive movement, including  \nCorrespondence and reprint requests to Jane M. Fedorczyk, PT, PhD, CHT, ATC, Department of Physical Therapy & Rehabilitation Sciences, Drexel University, 245 N 15th St Mail Stop 502, Philadelphia, PA 19102; e-mail: \u003C[jane.fedorczyk@drexel.edu](jane.fedorczyk@drexel.edu)>.  \n0894-1130/$ -see front matter 􀀁 2012 Hanley & Belfus, an imprint of Elsevier Inc. All rights reserved.  \ndoi:10.1016/j.jht.2011.12.001  \nactive muscle contractions and stretching over bony surfaces, with and without force. The prevalence of these tendinopathies increases with age and the amount of exposure to forceful repetitive movement.2 Overuse may occur in the workplace and in sport-related activities.  \nThis article reviews tendon structure and histopathological findings of common elbow, wrist, and hand tendinopathies. Implications for client management and further research in the areas of examination, diagnosis, prognosis, intervention, and outcomes will be discussed. Although any tendon in the upper extremity may develop a tendinopathy, the clinical considerations presented in this article will focus on the three tendon conditions commonly treated by hand therapists: tennis elbow, deQuervain’s disease, and trigger finger.  \nTENDON STRUCTURE  \nTendons provide the interface to transmit muscle force to bone to create joint movement. The composition of tendon is primarily collagen, ground substance, and tenocytes. A network of thin reticular connective tissue known as the endotenon surrounds and binds collagen fibers together to form the primary, secondary, and tertiary bundles that compose the tendon (Figure 1) . In addition to binding collagen fibrils together, the endotenon surrounds each of the collagen bundles. Tendon bundles are surrounded by two connective tissue layers called the epitenon and the paratenon. Together, these two layers are known as the peritendon. The paratenon, a layer of loose areolar connective tissue,","cbCaigem5xnWEUib","https://ap.wps.com/l/cbCaigem5xnWEUib","pdf",368629,11,"English","# Abstract\n# Tendon Structure\n## Core tendon tissue components\n## Tendon sheaths and pulleys\n## Innervation and pain receptors","[{\"question\":\"How does the article distinguish acute from chronic tendinopathy?\",\"answer\":\"Acute tendinopathy is activity-aggravated pain with an unknown pain source, which may involve inflammation around connective tissues or a symptomatic degenerative tendon. Chronic or long-standing tendinopathy refers to localized activity-induced pain that does not respond to nonoperative treatments.\"},{\"question\":\"Why can clinical observation alone be insufficient for tendinopathy?\",\"answer\":\"Clinical observation cannot determine whether insidious-onset pain is driven by inflammation or represents early symptomatic degeneration. Treatment choices may differ depending on which histopathological process is involved.\"},{\"question\":\"What tendon-structure elements are emphasized in the article?\",\"answer\":\"The article describes tendons as primarily collagen with ground substance and tenocytes, organized into bundles surrounded by endotenon, epitenon, and peritendon. It also covers wrist and hand fibrous sheaths, pulley systems, fibrocartilage related to gliding, and rich innervation with free nerve endings functioning as pain receptors.\"}]","Tendinopathies of the Elbow, Wrist, and Hand - Histopathology and Clinical Considerations | PDF",1791155819,28]