In chronic tenosynovitis, what changes occur in the tendon?

Chronic tenosynovitis is characterized by inflammation of the tendon sheath, often leading to significant alterations in the tendon structure and function. The condition typically results in locally thickened tendons, which can be attributed to ongoing inflammation and the accumulation of degenerative changes. As the condition progresses, the affected tendons may exhibit pain during movement and a sensation of crepitus, which is a grating or crackling sound or sensation that often accompanies the motion due to the roughened surfaces of the tendon.

This thickening is a result of changes in the tendon's matrix and the surrounding protective sheath. In chronic cases, the response of the body can lead to an increase in collagen and fibrous tissue, contributing to the thickening and further aggravating the tendon's ability to glide smoothly within its sheath. These symptoms—thickening, pain, and crepitus—are hallmark indicators of chronic tenosynovitis, making this option the most accurate representation of the changes that occur in the tendon.