OVERUSE TENDON CONDITIONS - TIME TO CHANGE A CONFUSING TERMINOLOGY

In overuse clinical conditions in and around tendons, frank inflammati on is infrequent, and is associated mostly with tendon ruptures. Tendi nosis implies tendon degeneration without clinical or histological sig ns of intratendinous inflammation, and is not necessarily symptomatic. Patients undergoing an operation for Achilles tendinopathy show simil ar areas of degeneration. When the term tendinitis is used in a clinic al context, it does not refer to a specific histopathological entity. However, tendinitis is commonly used for conditions that are truly ten dinoses, and this leads athletes and coaches to underestimate the prov en chronicity of the condition. Paratenonitis is characterized by acut e edema and hypermia of the paratenon, with infiltration of inflammato ry cells, possibly with production of a fibrinous exudate that fills t he tendon sheath, causing the typical crepitus that can be felt on cli nical examination. The term partial tear of a tendon should describe a macroscopically evident subcutaneous partial tear of a tendon, an unc ommon acute lesion. Most articles describing the surgical treatment of 'partial tears' of a given tendon in reality deal with degenerative t endinopathies. The combination of pain, swelling, and impaired perform ance should be labeled tendinopathy. According to the tissues affected , the terms tendinopathy, paratendinopathy, or pantendinopathy should be used.