ICD-10: M65.14

Other infective (teno)synovitis, hand

Additional Information

Approximate Synonyms

ICD-10 code M65.14 refers to "Other infective (teno)synovitis" specifically affecting the hand. This condition involves inflammation of the synovial membrane surrounding the tendons, often due to infection. Understanding alternative names and related terms can help in clinical documentation, coding, and communication among healthcare professionals. Below are some alternative names and related terms associated with this ICD-10 code.

Alternative Names

  1. Infective Tenosynovitis: This term is often used interchangeably with "infective (teno)synovitis" and emphasizes the infectious nature of the condition.

  2. Suppurative Tenosynovitis: This term highlights the presence of pus in the synovial fluid, indicating a bacterial infection.

  3. Pyogenic Tenosynovitis: Similar to suppurative tenosynovitis, this term refers to inflammation caused by pyogenic (pus-forming) bacteria.

  4. Infectious Tenosynovitis: A broader term that encompasses any tenosynovitis caused by infectious agents, including bacteria, viruses, or fungi.

  5. Tendon Sheath Infection: This term describes the infection of the tendon sheath, which is the structure that surrounds the tendon.

  1. Synovitis: General inflammation of the synovial membrane, which can occur without infection but is often related to tenosynovitis.

  2. Tendinitis: While not synonymous, tendinitis refers to inflammation of the tendon itself, which can accompany tenosynovitis.

  3. Septic Tenosynovitis: This term specifically refers to tenosynovitis caused by a bacterial infection, often requiring urgent medical intervention.

  4. Non-infective Tenosynovitis: This term is used to describe tenosynovitis that is not caused by an infection, often due to overuse or inflammatory conditions.

  5. Hand Infections: A broader category that includes various types of infections affecting the hand, which may involve tenosynovitis as a complication.

  6. Fistula or Abscess Formation: In severe cases of infective tenosynovitis, complications such as fistulas or abscesses may develop, necessitating surgical intervention.

Conclusion

Understanding the alternative names and related terms for ICD-10 code M65.14 is crucial for accurate diagnosis, treatment, and coding in medical practice. These terms not only facilitate better communication among healthcare providers but also enhance the clarity of medical records and billing processes. If you need further information on specific aspects of this condition or related coding practices, feel free to ask!

Description

ICD-10 code M65.14 refers to "Other infective (teno)synovitis, hand." This diagnosis is part of the broader category of synovitis and tenosynovitis, which are inflammatory conditions affecting the synovial membrane and the tendon sheaths, respectively. Below is a detailed clinical description and relevant information regarding this condition.

Clinical Description

Definition

Teno-synovitis is an inflammation of the synovial membrane that surrounds a tendon, often leading to swelling, pain, and restricted movement. When classified as "infective," it indicates that the inflammation is due to an infectious agent, such as bacteria, viruses, or fungi.

Symptoms

Patients with M65.14 may present with the following symptoms:
- Pain: Localized pain in the hand, particularly around the affected tendon.
- Swelling: Noticeable swelling in the hand or fingers, which may be accompanied by warmth and redness.
- Limited Range of Motion: Difficulty in moving the affected fingers or hand due to pain and swelling.
- Fever: In cases of severe infection, systemic symptoms such as fever may be present.

Etiology

The infective nature of this condition can arise from:
- Direct Infection: Bacterial infections can occur due to trauma, surgery, or injection into the tendon sheath.
- Hematogenous Spread: Infections from other body sites can spread through the bloodstream to the tendon sheaths.
- Underlying Conditions: Conditions such as diabetes or immunosuppression can predispose individuals to infections.

Diagnosis

Clinical Evaluation

Diagnosis typically involves a thorough clinical evaluation, including:
- History Taking: Assessing the onset, duration, and nature of symptoms, as well as any recent injuries or infections.
- Physical Examination: Evaluating the hand for signs of inflammation, tenderness, and range of motion.

Imaging Studies

  • Ultrasound: Can be used to visualize fluid accumulation in the tendon sheath.
  • MRI: Provides detailed images of soft tissues and can help assess the extent of the infection.

Laboratory Tests

  • Blood Tests: May include complete blood count (CBC) to check for signs of infection (e.g., elevated white blood cell count).
  • Culture and Sensitivity: Fluid from the tendon sheath may be aspirated and cultured to identify the causative organism.

Treatment

Management Strategies

Treatment for M65.14 typically involves:
- Antibiotics: Empirical antibiotic therapy is initiated based on the suspected organism, with adjustments made according to culture results.
- Surgical Intervention: In cases of abscess formation or severe infection, surgical drainage may be necessary.
- Supportive Care: Rest, ice, and elevation of the affected hand can help reduce swelling and pain.

Prognosis

The prognosis for patients with infective tenosynovitis largely depends on the timeliness of diagnosis and treatment. Early intervention can lead to favorable outcomes, while delays may result in complications such as tendon rupture or chronic pain.

Conclusion

ICD-10 code M65.14 encapsulates a significant clinical condition characterized by infective tenosynovitis of the hand. Understanding its symptoms, diagnostic approaches, and treatment options is crucial for effective management and improved patient outcomes. Early recognition and appropriate intervention are key to preventing complications associated with this condition.

Clinical Information

The ICD-10 code M65.14 refers to "Other infective (teno)synovitis" specifically affecting the hand. This condition is characterized by inflammation of the synovial membrane surrounding the tendons in the hand, often due to infectious agents. Understanding the clinical presentation, signs, symptoms, and patient characteristics associated with this condition is crucial for effective diagnosis and management.

Clinical Presentation

Definition and Overview

Teno-synovitis is an inflammation of the synovial sheath surrounding a tendon. When this condition is infective, it can lead to significant pain, swelling, and functional impairment. M65.14 specifically denotes cases where the infection is not classified under more common types, indicating a need for careful evaluation to identify the underlying cause.

Common Causes

Infective teno-synovitis can arise from various pathogens, including:
- Bacterial infections: Often due to Staphylococcus aureus or Streptococcus species.
- Fungal infections: Less common but can occur, particularly in immunocompromised patients.
- Viral infections: Certain viruses can also lead to synovitis.

Signs and Symptoms

Key Symptoms

Patients with M65.14 may present with a range of symptoms, including:
- Pain: Localized pain in the hand, particularly along the tendon sheaths.
- Swelling: Noticeable swelling around the affected tendons, which may be accompanied by warmth and redness.
- Limited Range of Motion: Difficulty moving the fingers or wrist due to pain and swelling.
- Tenderness: Increased sensitivity in the affected area, especially when pressure is applied.

Additional Signs

  • Fever: In cases of acute infection, patients may present with systemic symptoms such as fever and malaise.
  • Pus or Discharge: In severe cases, there may be visible discharge from the site of infection, indicating an abscess or severe inflammation.

Patient Characteristics

Demographics

  • Age: While teno-synovitis can occur at any age, it is more prevalent in adults, particularly those engaged in repetitive hand activities or those with underlying health conditions.
  • Gender: There may be a slight male predominance, although this can vary based on the underlying cause of the infection.

Risk Factors

  • Immunocompromised Status: Patients with weakened immune systems (e.g., due to diabetes, HIV, or cancer) are at higher risk for developing infective teno-synovitis.
  • Recent Injuries: Trauma or injury to the hand can predispose individuals to infections.
  • Chronic Conditions: Conditions such as rheumatoid arthritis or gout can increase susceptibility to infections in the synovial tissues.

Clinical History

  • Previous Infections: A history of prior infections or surgeries in the hand may be relevant.
  • Occupational Hazards: Jobs that involve repetitive hand movements or exposure to pathogens can increase risk.

Conclusion

Infective teno-synovitis of the hand, classified under ICD-10 code M65.14, presents with distinct clinical features, including localized pain, swelling, and limited motion. Understanding the signs, symptoms, and patient characteristics associated with this condition is essential for timely diagnosis and treatment. Early intervention can prevent complications such as chronic pain or loss of function, emphasizing the importance of recognizing the clinical presentation of this condition. If you suspect infective teno-synovitis, a thorough clinical evaluation and appropriate imaging or laboratory tests are recommended to confirm the diagnosis and guide management.

Diagnostic Criteria

The diagnosis of ICD-10 code M65.14, which refers to "Other infective (teno)synovitis" specifically in the hand, involves a combination of clinical evaluation, patient history, and diagnostic testing. Here’s a detailed overview of the criteria typically used for this diagnosis:

Clinical Presentation

  1. Symptoms: Patients often present with symptoms such as:
    - Swelling in the hand or wrist.
    - Pain and tenderness along the tendons or joints.
    - Limited range of motion in the affected area.
    - Warmth and redness over the affected tendons or joints.

  2. Duration of Symptoms: The duration and progression of symptoms can help differentiate between acute and chronic conditions, which is crucial for diagnosis.

Medical History

  1. Infection Risk Factors: A thorough medical history should include:
    - Recent infections or skin injuries in the hand or wrist area.
    - History of systemic diseases that may predispose to infections, such as diabetes or immunosuppression.
    - Previous surgeries or invasive procedures involving the hand.

  2. Occupational and Recreational Activities: Understanding the patient's activities can help identify potential exposure to pathogens, especially in cases of traumatic injuries.

Physical Examination

  1. Local Examination: A detailed physical examination is essential, focusing on:
    - Inspection for signs of inflammation (swelling, erythema).
    - Palpation to assess tenderness and warmth.
    - Assessment of range of motion and functional impairment.

  2. Joint and Tendon Assessment: Specific tests may be performed to evaluate the integrity and function of the tendons and joints involved.

Diagnostic Testing

  1. Imaging Studies:
    - Ultrasound: This can help visualize fluid collections or inflammation around the tendons.
    - MRI: Magnetic resonance imaging may be used for a more detailed view of soft tissue involvement and to rule out other conditions.

  2. Laboratory Tests:
    - Blood Tests: Complete blood count (CBC) may show elevated white blood cell counts indicating infection.
    - Culture and Sensitivity: If there is an abscess or fluid collection, aspiration may be performed to obtain samples for culture to identify the causative organism.
    - Serological Tests: These may be conducted to rule out specific infectious agents or inflammatory conditions.

Differential Diagnosis

  1. Exclusion of Other Conditions: It is crucial to differentiate M65.14 from other types of tenosynovitis or synovitis, such as:
    - Non-infective tenosynovitis (e.g., rheumatoid arthritis).
    - Gout or pseudogout.
    - Traumatic injuries or degenerative conditions.

  2. Consideration of Systemic Conditions: Conditions like septic arthritis or systemic infections should also be considered and ruled out.

Conclusion

The diagnosis of M65.14 requires a comprehensive approach that includes a detailed clinical assessment, thorough medical history, physical examination, and appropriate diagnostic testing. By systematically evaluating these criteria, healthcare providers can accurately diagnose other infective (teno)synovitis in the hand and initiate appropriate treatment. This may involve antibiotics, surgical intervention, or other management strategies depending on the severity and underlying cause of the infection.

Treatment Guidelines

When addressing the standard treatment approaches for ICD-10 code M65.14, which refers to "Other infective (teno)synovitis, hand," it is essential to understand the condition's nature, potential causes, and the typical management strategies employed in clinical practice.

Understanding Infective Teno-Synovitis

Infective teno-synovitis is an inflammation of the synovial membrane surrounding the tendons, often caused by bacterial infections. This condition can lead to significant pain, swelling, and functional impairment in the affected hand. The infection may arise from direct trauma, hematogenous spread, or contiguous spread from adjacent infections. Early diagnosis and treatment are crucial to prevent complications such as tendon damage or joint destruction.

Standard Treatment Approaches

1. Antibiotic Therapy

The cornerstone of treatment for infective teno-synovitis is antibiotic therapy. The choice of antibiotics typically depends on the suspected or confirmed pathogen. Commonly used antibiotics include:

  • Empirical Therapy: Initially, broad-spectrum antibiotics may be administered to cover common pathogens, including Staphylococcus aureus and Streptococcus species. Options may include:
  • Cefazolin or Vancomycin for suspected methicillin-resistant Staphylococcus aureus (MRSA) infections.
  • Clindamycin or Ampicillin/Sulbactam for polymicrobial infections.

  • Targeted Therapy: Once culture results are available, antibiotic therapy can be adjusted to target the specific organism identified.

2. Surgical Intervention

In cases where there is significant pus accumulation or if the infection does not respond to antibiotics, surgical intervention may be necessary. This can include:

  • Incision and Drainage: This procedure is often performed to remove purulent material and relieve pressure within the tendon sheath.
  • Debridement: In more severe cases, debridement of necrotic tissue may be required to promote healing and prevent further complications.

3. Supportive Care

Supportive measures are also critical in the management of infective teno-synovitis:

  • Immobilization: The affected hand may need to be immobilized using splints or casts to reduce movement and allow healing.
  • Elevation: Keeping the hand elevated can help reduce swelling.
  • Pain Management: Non-steroidal anti-inflammatory drugs (NSAIDs) may be prescribed to manage pain and inflammation.

4. Physical Therapy

Once the acute infection is controlled, physical therapy may be recommended to restore function and strength to the hand. This can include:

  • Range of Motion Exercises: To prevent stiffness and improve mobility.
  • Strengthening Exercises: To regain strength in the affected tendons and muscles.

Conclusion

The management of infective teno-synovitis of the hand (ICD-10 code M65.14) typically involves a combination of antibiotic therapy, possible surgical intervention, supportive care, and rehabilitation. Early recognition and treatment are vital to prevent complications and ensure optimal recovery. If you suspect an infection or are experiencing symptoms, it is crucial to seek medical attention promptly to initiate appropriate treatment.

Related Information

Approximate Synonyms

  • Infective Tenosynovitis
  • Suppurative Tenosynovitis
  • Pyogenic Tenosynovitis
  • Infectious Tenosynovitis
  • Tendon Sheath Infection
  • Septic Tenosynovitis
  • Non-infective Tenosynovitis
  • Hand Infections

Description

  • Inflammation of synovial membrane around tendon
  • Localized pain in hand or fingers
  • Noticeable swelling in hand or fingers
  • Difficulty moving affected fingers or hand
  • Fever present with severe infection
  • Direct infection from trauma or surgery
  • Hematogenous spread from other body sites
  • Underlying conditions like diabetes or immunosuppression

Clinical Information

  • Inflammation of synovial membrane surrounding tendons
  • Localized pain in hand along tendon sheaths
  • Noticeable swelling around affected tendons
  • Limited range of motion due to pain and swelling
  • Increased sensitivity in affected area
  • Fever in cases of acute infection
  • Visible discharge from site of infection
  • Prevalent in adults, particularly those with repetitive hand activities
  • Immunocompromised patients at higher risk

Diagnostic Criteria

  • Swelling in hand or wrist
  • Pain and tenderness along tendons
  • Limited range of motion
  • Warmth and redness over affected area
  • Recent infections or skin injuries
  • History of systemic diseases predisposing to infection
  • Previous surgeries or invasive procedures
  • Inflammation on local examination
  • Palpable tenderness and warmth
  • Assessment of range of motion impairment

Treatment Guidelines

  • Antibiotic Therapy
  • Cefazolin for suspected MRSA infections
  • Clindamycin for polymicrobial infections
  • Incision and Drainage for pus accumulation
  • Debridement for necrotic tissue removal
  • Immobilization with splints or casts
  • Elevation to reduce swelling
  • Pain Management with NSAIDs
  • Range of Motion Exercises for mobility
  • Strengthening Exercises for tendon and muscle strength

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