Chronic proliferative synovitis of the knee joint. What is synovitis? Treatment for chronic disease

Exudative synovitis is an inflammatory process in the synovium of the joint, accompanied by the release of a large amount of effusion (exudate). The pathology is quite common and occurs among people of all age groups. Most often, large joints are affected - knee, hip, ankle. The primary symptoms are severe joint swelling and pain on exertion.

A large accumulation of fluid in the synovial bursa causes discomfort and pain in the joint

Synovitis is an inflammation of the synovial (inner) lining of the joint. The word “exudative” in the name of the disease means the release of a large amount of effusion - fluid, the accumulation of which leads to the formation of severe edema. Swelling is one of the first symptoms of the disease, and if you notice it, it is recommended to immediately consult a doctor.

In ICD-10, synovitis is coded M65. Exudate accumulated in the joint can be of different nature. With purulent inflammation, the disease will be designated as M65.1 - infectious synovitis. If the nature of the development of the pathology is unspecified, it is encoded with the code M65.9.

Causes of the disease

Inflammation of the synovial membrane develops due to:

infections;
allergic reaction;
joint injuries;
chronic joint diseases;
systemic diseases;
obesity.

Infections cause reactive synovitis. It can occur in an exudative form, which indicates the presence of a large amount of effusion. In fact, exudative can be called any form of disease accompanied by the release of exudate, both aseptic and purulent.

Allergic reactions can cause inflammation in the joint. In this case, the inflammatory reaction manifests itself in response to an immunopathological process occurring in the body of an allergic person.

The most common cause of synovitis is joint injury. The disease in this case develops due to disruption of the movement of synovial fluid, which accumulates and begins to put pressure on the joint membrane from the inside. Inflammation can also be caused by damage to the membrane due to impact or compression.

Synovitis is often a complication of arthrosis and arthritis. Quite often, this pathology is observed in psoriatic or gouty arthritis.

Synovitis can develop as a complication of systemic lupus erythematosus or rheumatoid arthritis. The disease is often encountered by patients with diabetes and people with metabolic disorders that lead to obesity. In obesity, the development of synovitis is associated with severe stress on the joints. In this case, the knee or hip joint is most often affected.

Purulent exudative synovitis develops against the background of joint infection

There are several classifications of the disease - according to localization, cause of inflammation of the synovial membrane and type of exudate.

Exudative synovitis occurs:

purulent;
serous;
serous-fibrinous;
hemorrhagic.

Purulent exudative synovitis develops against the background of infection of the joint. The pathology is characterized by the release of pus and the formation of an abscess. As a rule, the cause of inflammation is Staphylococcus aureus.

Serous exudative synovitis is manifested by the accumulation of lymph in the area of inflammation. When puncturing the articular membrane with further examination of the exudate, a significant part of lymph and intercellular fluid is found in its composition.

Serous-fibrinous synovitis is characterized by the presence of protein (fibrin) in the effusion. The hemorrhagic form of the disease got its name due to the admixture of blood in the exudate.

One of the rare forms of the disease is exudative-proliferative synovitis. With this type of pathology, the inflammatory process is combined with a change in the structure of the tissues of the synovial membrane. They begin to grow with the formation of villi and nodules. The second name of the disease is pigment villous synovitis.

Symptoms of the disease

The main symptom of the pathology is severe swelling. It grows rapidly and can reach impressive sizes. When the knees or elbows are affected, the size of the joint increases several times.

At the same time, not all joints swell greatly during synovitis. When the synovium of the hip and ankle joint is inflamed, the swelling may be almost invisible.

With synovitis, there is pain during exertion. At the initial stage of the disease, pain appears only during prolonged exercise; As the pathology progresses, discomfort becomes noticeable with every flexion and extension of the joint. As a rule, pain from synovitis goes away with rest. In severe forms of inflammation, the pain increases in the morning and decreases in the evening.

Since inflammation is observed in large joints, a decrease in the range of motion of the affected limb develops. In the initial stages, movements are practically not limited, but as the disease progresses, the motor function of the joint may deteriorate. With severe synovitis of the knee, joint blockades often develop.

With purulent exudative synovitis, the following symptoms are observed:

hyperemia (redness) of the skin in the affected area;
increased body temperature;
symptoms of intoxication.

The skin around the swollen joint becomes hot to the touch, and acute pain is observed upon palpation.

Otherwise, the symptoms of synovitis differ little, regardless of the location of the inflammation and its causes.

How dangerous is the disease?

If the pathology is not treated, it becomes chronic.

Synovitis occurs in an acute form. If the pathology is not treated, it becomes chronic, characterized by periodic exacerbations. The inflammatory process can spread to the joint capsule (arthritis) and the tissue around the joint (bursitis). In the absence of treatment, the trophism of the synovial fluid is disrupted and the nutrition of the cartilage tissue deteriorates, which leads to its degeneration (arthrosis).

Changes in the structure of the synovial membrane lead to the formation of villi and nodes that disrupt movement in the joint. In severe cases, tissue fragments (“joint mouse”) appear, which lead to blockade (immobility) of the joint.

Diagnostics

The disease is easily diagnosed visually due to characteristic swelling. To clarify the diagnosis, the doctor may refer the patient for an ultrasound. This examination allows you to visualize the condition of the soft tissues around the joint and exclude the presence of growths and salt deposits, which can lead to inflammation.

To clarify the nature of synovitis, a joint puncture is performed. Using a needle, a small amount of exudate is removed, the study of which makes it possible to clarify the type of inflammatory process (purulent or aseptic).

Principles of drug treatment

Medicines help relieve pain and swelling of the affected joint

The main method of treating the disease is puncture. Puncture of the synovium of the joint and removal of some of the exudate leads to an immediate decrease in the severity of symptoms. When the exudate is removed, the pressure on the synovial membrane decreases, as a result of which the pain syndrome subsides.

After puncture, immobilization of the joint is necessary. When the joints of the legs are affected, orthoses are used; The patient is prescribed to move with the help of a crutch. For synovitis on the arms, bandages and bandages are used. Immobilization allows you to reduce the load on the joint, which has a beneficial effect on the trophism of the synovial membrane and reduces the inflammatory process.

Further treatment depends on the form of the disease. Until the inflammatory process is stopped, there is a risk of re-enlargement of the joint due to the accumulation of effusion.

The exact treatment regimen depends on the type of exudative synovitis. If the exudate is represented by purulent discharge, antibacterial therapy is necessary. Drugs from the group of macrolides, fluoroquinolones, tetracyclines or penicillins are used. The choice of antibiotic depends on the causative agent of inflammation and the patient’s tolerance to a particular drug. As a rule, antibacterial therapy is carried out in a short course; treatment rarely exceeds 7-10 days.

For the aseptic form of exudative synovitis, treatment with non-steroidal anti-inflammatory drugs is practiced - Ibuprofen, Diclofenac, Nimesulide. Their use together with puncture and immobilization of the joint gives a good result, quickly relieving inflammation.

In severe cases, injections of glucocorticosteroids are indicated. Prednisolone, Hydrocortisone, Betamethasone are used in the treatment of synovitis. The injection is made directly into the joint cavity. As a rule, one injection is enough for the inflammation to subside.

Rehabilitation therapy

Physiotherapy helps joints recover after illness

After stopping the acute inflammatory process, a course of physiotherapy and drugs is prescribed to restore trophism in the joint. For synovitis, therapeutic compresses, magnetic therapy, electrophoresis, and phonophoresis are often used. In the exudative form of inflammation, such methods help reduce swelling and normalize joint mobility.

To prevent complications of synovitis, chondroprotectors are prescribed. These drugs improve the movement of synovial fluid and ensure the supply of nutrients to cartilage tissue. Additionally, the doctor may recommend dietary supplements and vitamins to improve joint function.

Surgical treatment

As a rule, exudative synovitis can be treated quite successfully with medications. In some cases, surgery may be indicated. The operation is indicated for purulent exudative synovitis. The intervention is aimed at removing purulent exudate to prevent infection of surrounding tissues.

When the synovial membrane grows, it must be excised. This is done by arthroscopy.

Forecast

The success of treatment of synovitis depends on timely diagnosis

With timely detection of the initial symptoms of the disease and comprehensive treatment, the prognosis is usually favorable. Treatment of acute synovitis takes several weeks, of which at least two are allocated for rehabilitation and physical therapy.

In advanced cases, the disease becomes chronic. If changes begin in the tissue of the synovial membrane, surgery cannot be avoided. In some cases, irreversible changes in the joint are noted, so the patient is prescribed endoprosthetics.

The success of treatment depends on timely diagnosis of the disease. If edema or swelling appears in the joint area, it is recommended not to delay a visit to a specialist.

The most complete answers to questions on the topic: “exudative proliferative synovitis of the knee joint.”

Proliferative synovitis is a joint disease characterized by inflammation of the synovium. It can occur in any joint, but the most common is proliferative synovitis of the knee joint. This is explained by the most common knee injuries. Inflammation in several places most often occurs with polyarthritis and other extensive diseases.

Due to the appearance and accumulation of exudative fluid in the joint cavity, pressure increases, disrupting motor functions. In this case, synovial tissue grows, which can gradually become a thick, massive formation.

The disease is rarely diagnosed in the acute stage, imperceptibly becomes chronic and causes destructive changes in the affected organ.

Proliferative synovitis goes through 4 stages in its development:

Proliferation of the synovial membrane without proliferation of villi, or it is insignificant.
Foci of villous accumulations begin to form on the thickened tissue.
Filling the lateral parts of the joints with villi, which makes up more than half of the entire synovial membrane. The top part is not affected.
Villous proliferation spreads throughout all sections, becoming diffuse.

Symptoms

The main symptom of the disease is pain. The nature and intensity depend on the severity of the process and the pressure on the nerve endings. Pain causes limited movement and forced positioning. There is a special method for determining the intensity of pain in points, where 0 is absent, 1 is weak, 2 is moderate, 3 is strong and 4 is very strong pain.

The diseased joint usually swells due to the presence of pathological accumulation of fluid in it and becomes deformed.

Common symptoms include fever, most often subfibrile, weakness and rapid onset of fatigue.

With a long course of the disease, atrophy of the surrounding muscles gradually occurs due to the lack of active movements.

Causes

There can be a lot of them. First of all, synovitis is divided into infectious and non-infectious. In the first case, the cause of the development of the disease can be any pathogenic microorganism that causes inflammatory processes.

Other causes include endocrine system disorders, allergens, trauma and neurogenic factors.

Diagnostics

In addition to external examination and palpation of the diseased organ, the doctor may prescribe an x-ray to assess the consequences of synovitis. Ultrasound is used to measure the synovium and the volume of fluid in the cavity.

Arthroscopy allows you to visually examine the affected membrane of the diseased joint. It perfectly complements ultrasound, so both studies are often used to most accurately assess the condition of the inflamed organ.

Treatment

Complex therapy is usually carried out, including many methods. Before talking about surgical intervention, you should make sure that conservative treatment is ineffective. It goes in several directions:

Elimination of the main cause of the disease. Prescription of antibacterial therapy for infectious diseases, antiallergic drugs, treatment of endocrine disorders, etc.
Elimination of symptoms of synovitis.
General strengthening of the body.
Therapy for impaired motor functions.
Physiotherapeutic procedures and physical therapy for the final rehabilitation of the joint.

Depending on the severity and stage of the disease, local use of anti-inflammatory drugs, such as gels and ointments, is prescribed. Currently, preference is given to drugs containing methyl salicylate, capsaicin, diclofenac and menthol. The presence of these components effectively reduces inflammation and its symptoms, reducing pain and swelling. These products include Dicloran Plus, which combines all of these substances.

When exudative fluid accumulates in the cavity, hormonal corticosteroids are administered directly into the joint after puncture.

At first, it is necessary to immobilize the affected joint using a splint or pressure bandage. Prolonged immobility is contraindicated, as it causes degeneration of the muscle layer and stiffness of the joint itself.

As an additional folk method, comfrey herb is used, which helps regenerate cartilage and bone tissue. Its use is possible after the permission of the attending physician.

If therapeutic treatment is ineffective and irreversible processes form in the joint, surgical intervention is performed - synovectomy. It can be total, partial and subtotal. It involves excision of the damaged synovial membrane and removal of menisci and foreign bodies.

If proliferative primary or secondary synovitis is not recognized and treated in time, this can lead to serious consequences in the form of complications and irreversible changes in the joint. Ultimately, the affected organ will become completely immobilized, normal blood circulation and lymph flow will be disrupted.

To prevent such troubles, it is necessary to promptly consult a doctor at the first signs of the disease and undergo a routine medical examination every year.

The knee joint belongs to the group of largest joints. It has a complex structure and takes on a large load. Injuries, infections, allergies and other causes can cause inflammation of the knee joint. One of the most common diseases is synovitis of the knee joint.

Synovitis of the knee joint is an inflammation of the synovial membrane of the articular capsule of the knee joint with the formation of exudate or effusion. Synovial fluid is always present in the knee joint, but when synovitis occurs, its amount increases significantly. If an infection occurs, the effusion turns into purulent contents.

Symptoms

The first manifestations of synovitis occur within a few hours, but more often on the second day.

And they have three main manifestations:

increase in size and deformation of the joint due to the accumulation of fluid in the joint cavity;
limitation of motor function of the joint;
the pain syndrome is long-lasting and aching.

Sometimes there may be an increase in temperature in the joint area in the absence of hyperemia of the periarticular tissues. In most cases, this disease develops without significant symptoms and requires additional diagnostics.

Types and causes of the disease

Most often, synovitis of the knee joint occurs after an injury, due to a fall or bruise. In addition, synovitis can be caused by pathological changes in the joint. For example, if metabolic processes in the body are disrupted, the immune system malfunctions, or as a consequence of complications of another disease.

Causes of synovitis of the knee joint:

injury;
systemic or autoimmune disorders;
secondary manifestation of another disease.

Structure of the knee joint

Synovitis can occur in acute and chronic forms, divided into:

Infectious

Occurs when pathological microorganisms penetrate into the synovial fluid. The joint fluid becomes cloudy and purulent, containing a large number of bacteria and leukocytes. Pathogenic bacteria can enter the joint during an open injury or be introduced through the blood (hematogenous route) or lymph (lymphogenous route) from internal foci of infection. In turn, infectious synovitis is divided into:

nonspecific synovitis, with the determination of pathogenic microorganisms in the synovial fluid: pneumococci, streptococci, staphylococci, etc.;
specific synovitis, containing pathogenic microorganisms: syphilis pathogens, tuberculous mycobacteria.

Aseptic

With this type of synovitis, the joint effusion is more transparent with the characteristic presence of a large number of lymphocytes. Develops against the background of injury or an allergic reaction of the body.

Reactive

It manifests itself as an allergic reaction of the body to mechanical or toxic effects on the knee joint. Causes may include: autoimmune or systemic diseases, excessive exercise, bad habits, reactions to medications, certain foods or other allergens.

The doctor’s task is to identify the cause that caused such a secondary manifestation of the disease as synovitis of the knee joint. After diagnosis, treatment is carried out aimed at eliminating the root cause of synovitis.

Exudative-proliferative

Most often occurs due to injury. It is characterized by a large amount of turbid exudate, rich in protein, hematogenous and histogenic cells.

Post-traumatic

The most common manifestation of the disease. It is the body’s reaction to intra-articular damage and destruction of joint tissue.

Chronic

Has its own symptoms. Swelling of the joint and local increase in temperature are not pronounced. Stiffness of the joint increases gradually. There are: serous, serous-fibrinous and villous forms of chronic synovitis.

Serous

Rarely seen. At the onset of the disease, clinical manifestations are mild. Most often, patients identify complaints:

general fatigue;
fatigue when walking;
slight restriction of movement in the joint;
aching pain in the knee.

During the diagnostic process, the content of effusion in the diseased joint is revealed, which develops into hydrarthrosis (hydropsis of the joint). This causes sprains and loosening of the joint, leading to the risk of dislocation.

Serous-fibrinous synovitis

Causes excessive production of joint fluid by the synovial membrane, which distends the joint. At the same time, the synovial membrane becomes thinner, and fibrous deposits begin to form on it. Fibrous deposits reduce the elasticity of the synovium and prevent the outflow of joint fluid. At the same time, the fibrous membrane of the joint cavity thickens, leading to fibrosis. This type of synovitis requires immediate treatment, as it certainly leads to joint deformation and limitation of motor function.

Villous synovitis

It is characterized by a high content of fibrin in the exudate in the form of threads and clots, which tend to thicken, forming intra-articular bodies. It occurs with the formation of hypertrophied and sclerotic villi, which are capable of detaching, forming rice bodies and chondromic bodies.

Diagnostics

To clarify the diagnosis, a number of studies of the knee joint are performed.

MRI, radiography and ultrasound. These types of diagnostics are absolutely painless, informative, carried out superficially and without additional incisions and tissue punctures. Unlike puncture and arthroscopy, MRI, radiography and ultrasound do not have a therapeutic load.

General blood test and additional examinations. They are carried out for synovitis of a secondary nature. The success of treatment of synovitis depends on establishing a true diagnosis and correctly administered therapy.

First of all, a diagnosis of the knee joint and the whole body is carried out to determine the cause of synovitis. The choice of course of treatment depends on the diagnosis and the root cause of the disease.

Stages of treatment:

Puncture or arthroscopy are considered as the first step in the treatment of synovitis. When performing diagnostics using these methods, the knee joint is washed, excess fluid is removed from it and medications are administered.

The most common procedure is puncture of the knee joint. The procedure is painful, but it also carries a therapeutic load. The resulting liquid is sent to the laboratory for analysis and determination of the nature of the inflammation.

Step-by-step instructions for performing a puncture of the knee joint:

Step 1. All fluid is removed from the joint capsule using a syringe.

Step 2. Rinsing the joint with saline solution to cleanse possible infection.

Step 3. Administration of the drug.

After removing excess fluid, the patient immediately feels relief.

Arthroscopy is an informative, low-traumatic method. Allows you to determine intra-articular pathology, causes of pain and carry out treatment.

Stages of arthroscopy:

Step 1. Through a small incision, the doctor inserts a miniature instrument called an arthroscope.

Step 2. An image of the joint is displayed on the screen.

Step 3. The surgeon is able to detect the damage and carry out the necessary treatment.

The reliability of this procedure is 95-100%. For the patient, arthroscopy is almost painless and the patient can leave the clinic within 1-2 days after the diagnosis.

Immobilization. To ensure rest, a tight bandage is applied to the joint. For synovitis complicated by infection, it is recommended to apply a hard splint or plaster.

Drug treatment. To relieve the inflammatory process, suppuration and to fight infection, the following are prescribed:

non-steroidal anti-inflammatory drugs – suppress the inflammatory process and reduce pain (indomethacin, ibuprofen, voltaren, diclofenac);
antibiotics - are introduced into the joint cavity immediately after the puncture to prevent the addition of a secondary infection or suppress the bacterial nature of the inflammation;
corticosteroids - prescribed for intra-articular administration in case of malignant disease (dexamethasone, Kenalog-40);
inhibitors of proteolytic enzymes - indicated in the treatment of chronic synovitis with large formation of effusion and infiltration of the joint (trasylol, gordox);
microcirculation regulators (ATP, nicotinic acid, trental, troxevasin);
Dietary supplements for restoring the structure of cartilage tissue and maintaining the body after an illness.

Physiotherapeutic procedures. After relieving the inflammatory process, it is recommended to conduct a course of magnetic therapy, electrophoresis, UHF or phonophoresis for restorative and supportive purposes.

Physical therapy complex. A special set of exercises will help restore motor function of the joint.

In many ways, the prognosis for the treatment of synovitis depends on the nature of the pathogen, the general condition of the patient and the chosen treatment tactics. Under favorable conditions, the treatment can restore full motor function of the joint, but joint stiffness may remain as a consequence.

When purulent synovitis is detected, the patient’s life is threatened due to blood poisoning. In acute cases of the disease, hospitalization is indicated. If you suspect synovitis of the knee joint, you should consult a doctor for a diagnosis and adequate treatment.

Synovitis– inflammation of the synovium with the formation of effusion. As a rule, the knee joint is affected. Usually the inflammation progresses in one joint. Damage to multiple joints is almost never seen.

Synovitis can form due to infection, injury, allergies, hormonal diseases and metabolic disorders. It is expressed by malaise, increased joint volume, pain and weakness. When a joint becomes infected, signs of intoxication appear. To be exempt from military service, synovitis must indicate dysfunction of a large joint.

Types and classification of the disease

Depending on the course of synovitis, it can be:

Spicy– manifested by swelling, pain, hyperthermia and thickening of the synovial membrane.

Chronic– fibrous changes are formed in the joint capsule. Sometimes the villi of the synovial membrane become enlarged, and villous synovitis develops. The resulting “rice bodies” float in the fluid and further injure the synovial membrane. This form of the disease occurs infrequently and is a consequence of incorrect and untimely treatment of acute forms of synovitis or the result of latent, low-grade inflammation in the body. Symptoms of the chronic form are less pronounced.

Taking into account the type of inflammation and the nature of the effusion, the disease is divided into serous, hemorrhagic, purulent And serous-fibrinous.

Taking into account the cause of the development of synovitis, they distinguish infectious, aseptic And allergic form of the disease.

Types of synovitis

1. Pigmented villonodular(PVS) - manifested by the proliferation of synovium, hemosiderin staining, the formation of villi, nodular masses and pannus. This is a fairly rare pathology and occurs at a young age. The disease develops over a long period, increasing swelling and pain, which are usually associated with injury. During an exacerbation, there is effusion, a local increase in temperature, limited mobility and a change in the shape of the joint. On an x-ray, the changes are almost invisible, sometimes disturbances in the form of surface erosions are noted.

2. Reactive- limitation in the functioning of the joint is a consequence of the inflammatory process taking place in its cavity. In this case, fluid accumulates in the synovial membrane, a “dull” pain develops when walking, the joint is increased in volume, its shape is changed, and movements are limited. Usually the right or left knee joint is affected. This type of disease is secondary in nature against the background of the underlying pathology. Consequently, the main therapy is associated with the elimination of the underlying disease, and treatment of synovitis itself consists of joint puncture with the administration of antibiotics and corticosteroids, immobilization, NSAIDs and physiotherapy.

3. Post-traumatic- this form of the disease occurs most often and is the body’s reaction to intra-articular damage. They develop as a result of injury (chondropathy, rupture of the cruciate ligaments or meniscus). Sometimes this type of disease is mistaken for infectious arthritis or hemarthrosis. In acute cases, deformation of the joint occurs, severe pain, and stiffness in the joint are noted. The chronic form is manifested by aching pain, protrusion of the patella, fatigue and dropsy of the joint. This provokes the formation of dislocations, sprains and complete immobilization.

4. Moderate- any inflammatory diseases of the joint, for example, arthrosis, can develop into moderate synovitis with clear characteristic symptoms.

5. Minimum– the reasons are the same as for moderate synovitis; for treatment, the use of a pressure bandage is sufficient.

6. Suprapatellar- fluid accumulation and inflammation of the synovial membrane occurs above the patella.

7. Exudative- develops without visible injuries, that is, it is primary synovitis. It is usually caused by irritation of the inner surface of the joint capsule as a result of meniscus tear, cartilage injury, or joint instability.

8. Recurrent- accompanied, as a rule, by a chronic form of hydrarthrosis with the formation of synovial membrane hypotrophy and fibrosis. Dropsy complicates the course of the disease and causes degenerative disorders.

9. Villous- the villi of the inner lining of the joint grow, fibrinous formations appear, leading to severe disorders of lymphatic drainage and blood circulation in the joint area.

10. Secondary- the appearance of this form is caused by the accumulation of products of destruction of cartilage tissue in the joint. The resulting antigens are perceived as foreign material, which leads to chronic inflammation. The course of the disease is similar to chronic arthritis.

11. Transitory- usually the pathology affects children aged 1.5 – 15 years. The disease develops acutely. Pain appears in the morning, movements in the joint are limited, and its location is changed. X-rays show widening of the joint space. The duration of the illness is 14 days. Doctors suggest that a child may develop this form of synovitis after suffering from pharyngitis or tonsillitis, prolonged walking or injury. If the disease is not treated promptly, lameness may develop.

12. Exudative-proliferative– develops as a result of injury and is associated with the production of a large volume of exudate (turbid, protein-rich fluid containing joint and blood breakdown cells). This form of the disease usually affects the hip joint.

There are 4 degrees of proliferative form of pathology:

1. Thickening of the synovium without significant proliferation of villous tissue;

2. Formation of focal accumulations of villi caused by thickening of the synovium;

3. The lateral sections of the joint are completely covered with villi;

4. Villi cover all parts of the joint.

According to localization, synovitis is classified:

Ankle joint;

Temporomandibular joint;

Knee and hip joint;

Hand (wrist) and elbow joint;

Shoulder joint;

Big toe and foot.

Symptoms and signs

Synovitis typically affects one joint; very rarely, the pathology is multiple.

General symptoms:

Limitation of movement in the joint and pain during exercise;

Swelling and change in the outline of the joint;

Malaise, general weakness;

Hyperthermia of the skin in the affected area, hot to the touch.

All signs of the disease can be more or less pronounced depending on the form of the pathology and the individual characteristics of the patient. Infectious synovitis is manifested by a rapid increase in symptoms, with hyperthermia over 38°, the formation of pain and a feeling of pressure in the joint. In just a few hours, manifestations of intoxication develop (restlessness, headache, pallor) and the joint swells.

With non-infectious synovitis, the symptoms increase slowly, first of all there is discomfort in the joint and aching pain during exercise. After a few days or weeks, the pain increases, swelling appears, and the joint becomes deformed. Sometimes the signs of the disease disappear on their own, usually in the absence of stress, and independent recovery is possible.

Complications

With synovitis, complications may develop:

Purulent arthritis - appears when the purulent process spreads to the fibrous membrane of the joint capsule.

Gonarthrosis or arthrosis deformans - the hyaline cartilage covering the bony condyles is affected. This type of arthrosis is the most common and develops over several years.

Panarthritis - is formed when the cartilage, bones and ligaments of the joint are involved in the purulent process.

The disease is rarely diagnosed in the acute stage, imperceptibly becomes chronic and causes destructive changes in the affected organ.

Proliferative synovitis goes through 4 stages in its development:

Proliferation of the synovial membrane without proliferation of villi, or it is insignificant.
Foci of villous accumulations begin to form on the thickened tissue.
Filling the lateral parts of the joints with villi, which makes up more than half of the entire synovial membrane. The top part is not affected.
Villous proliferation spreads throughout all sections, becoming diffuse.

Symptoms

The diseased joint usually swells due to the presence of pathological accumulation of fluid in it and becomes deformed.

Common symptoms include fever, most often subfibrile, weakness and rapid onset of fatigue.

With a long course of the disease, atrophy of the surrounding muscles gradually occurs due to the lack of active movements.

Causes

Other causes include endocrine system disorders, allergens, trauma and neurogenic factors.

Diagnostics

Treatment

Elimination of the main cause of the disease. Prescription of antibacterial therapy for infectious diseases, antiallergic drugs, treatment of endocrine disorders, etc.
Elimination of symptoms of synovitis.
General strengthening of the body.
Therapy for impaired motor functions.
Physiotherapeutic procedures and physical therapy for the final rehabilitation of the joint.

When exudative fluid accumulates in the cavity, hormonal corticosteroids are administered directly into the joint after puncture.

Anyone who has developed an inflammatory process in the synovium should know about the treatment of synovitis. Often patients with a similar diagnosis are prescribed surgery. Most often, pathology develops in the knee, ankle, elbow and wrist joints, with changes affecting one or more joints. Synovitis can affect the tendons of the long head of the biceps and the temporomandibular joint, as well as the wrist.

Synovitis is an inflammatory process in the synovium that limits the normal functionality of the musculoskeletal system.

Basic information about the disease

The essence of the pathology is that under the influence of certain factors (damage and trauma, infectious processes, allergies), the synovial membrane becomes inflamed and effusion is formed. This phenomenon is accompanied by general intoxication of the body, loss of strength, weakness, pain and enlargement of the joint; synovitis often develops in rheumatoid arthritis.

What types are there?

Depending on the side of the lesion, there is left-sided and right-sided synovitis. According to the nature of the course of the disease, it is divided into chronic and acute. In the acute form, redness and swelling of the membrane are observed; the effusion externally resembles an almost transparent liquid; in special cases, fibrin particles are found. The second form is characterized by the progression of fibrotic processes in the capsule; deposits appear that hang from the articular cavity. Depending on the cause of development, the classification provides the following types:

Exudative-proliferative synovitis. One of the most commonly diagnosed forms, it develops as a result of serious injuries.
Villous nodular synovitis. The formation of special villonodular structures is characteristic. Many patients are faced with the problem of cystic formation.
Purulent and serous. To confirm the diagnosis, it is necessary to carry out. It occurs as a result of bruises and injuries that affect tissue, bursa and tendons.
Pigmented villous. Severe pigmentary synovitis is more common in young patients under 30 years of age.
Recurrent. Hypertrophy of the synovial membrane occurs.
Infectious synovitis. Among the pathogens are streptococci, staphylococci and other microorganisms. They enter the articular surface after injury through the blood or lymph.

Causes of the problem

Synovitis can develop due to injuries, infections, heavy loads, obesity, and allergies.

According to experts, a number of the following factors predispose to the development of pathology:

Damage and injury. The risk group includes athletes who injure the joint capsule every day.
Infectious processes. After damage, the capsule ceases to function as a barrier, thereby opening the path to infection.
Complications after illness. The cause can be both joint pathologies (bursitis, rheumatoid arthritis) and sexually transmitted diseases, for example, gonorrhea.
Allergy.
Torn posterior horn of the medial meniscus.
Increased weight.

What are the symptoms?

The disease has its own special symptoms. General symptoms of synovitis, characteristic of both forms, are as follows:

Limited mobility of limbs. Synovitis in rheumatoid arthritis is characterized by an increase in pain intensity, and it is difficult for the patient to walk.
Mild tissue swelling develops.
The outline of the articular surface changes.
Prostration.
The skin around the damaged area is hot.

Chronic synovitis is characterized by an increase in the membrane. As a result, the joint becomes loose, and the patient runs the risk of dislocation. In the acute form, inflammation of the foot joint often occurs, the main impact falls on the area of the big toe. While walking, patients note pain and redness of the skin in the phalanx area, and the quality of life deteriorates.

If you ignore the symptoms and do not treat synovitis, there is a risk of developing complications that affect a person’s health and life.
Why is synovitis dangerous?

Synovitis can become a source of dangerous suppuration and cyst formation.
Symptoms of the disease do not appear immediately, but after a few days, and in the future the following pathological processes may develop against the background of the underlying disease:
purulent form of arthritis;
the synovial membrane is thickened;
damage to hyaline cartilage;
state of sepsis;
cyst formation;
panarthritis;
soft tissue phlegmon;
increase in body temperature.

Diagnostic methods
The diagnosis of “acute synovitis” is made only after a comprehensive study of all indicators. The process begins with an examination, when the specialist has the opportunity to examine a small area of the lesion, note the temperature of the skin, color, and also determine the mobility of the limb. After this, the laboratory checks for blood tests, in which eosinophils, high iron levels and other uncharacteristic changes are detected. A mandatory part of the check is a hardware examination, including x-rays, MRI and ultrasound. Using X-rays and other tests, you can visualize the problem and understand the extent of the consequences.

Treatment prescribed for synovitis
It makes no sense to count on a short duration of procedures. The problem cannot be cured using one “magic” pill. The course of therapy for synovitis in adults lasts up to 3 weeks, and it is worth talking about the complete restoration of joint activity only after 2-3 months. During this period, it is recommended to take maximum care of your health, prevent infectious diseases, eliminate dangerous physical activity, and fully comply with the recommendations.

Pharmacy drugs
The therapeutic program includes several options for combating pathology. The most commonly used method is to stop the occurrence of the inflammatory process and eliminate pain using medications. Drugs are prescribed for the treatment of synovitis of the mandibular joint and other areas directly by a doctor; it is prohibited to prescribe drugs on your own.
For synovitis, the doctor will definitely prescribe anti-inflammatory medications.
The acute type of synovitis in adults can be cured with antibiotics and intramuscular injections, gradually switching to tablet form. The therapy uses glucocorticoids and non-steroidal anti-inflammatory drugs, the dosage of which must be monitored by a specialist. If adverse reactions and complications occur, it is necessary to change treatment tactics.
The most dangerous complication is loss of basic joint function. As large amounts of fluid accumulate, the ligaments weaken. A loose joint increases the risk of subluxation or even dislocation.

What is immobilization?
To treat bilateral synovitis of the knee joint, it would be wise to use the option of immobilizing the limb, since in some cases the joint becomes loose, which increases the risk of dislocations and other injuries. There are several ways to immobilize a joint. The first option is to use a plaster cast for up to 2 weeks. This treatment measure is relevant in case of a pronounced inflammatory process. The second option is used in case of reducing the intensity of synovitis using a special medical device - an orthosis.

Recovery Exercises

Sit on the floor and lightly grab the joint with your hands. Perform circular rotational movements of the knee in different directions. At a slow pace 10–20 times.
Sit on the edge of the sofa and begin to slowly flex and extend the affected leg. You can help yourself with your hands, this is done 10–15 times. Then bend both legs at the same time.
Stand up straight and hold onto a support with one hand. Bend the affected leg at the knee, lift it, straighten it, lower it. Perform 10–15 times.

Used to prevent injuries and for postoperative rehabilitation. They perfectly fix and support the knee joint after removing the plaster cast, provide a light massage and a slight warming effect.

Knee pads are often used instead of elastic bands because they are more comfortable to use.

Physiotherapy

Basic physiotherapy for synovitis:

Painkiller: electrophoresis, phonophoresis, laser therapy.
Anti-inflammatory: medicinal electrophoresis and phonophoresis.
Improves vascular microcirculation: UHF therapy, magnetic therapy.

Treatment with Almag-02 device

The modern Almag physiotherapeutic device has been used to treat patients with synovitis for more than 15 years. The therapeutic effect is provided by a running pulse of a magnetic field. It helps eliminate joint pain and inflammation during synovitis, and stops degenerative changes in bones.

Massage

Before massage, apply any massage oil, Johnson's oil, to the joint. The massage is done once a day for 10 minutes, 10-14 days in a row. After the massage, it is advisable to apply ice for 1-2 minutes. You can also do a massage yourself.

It is necessary to work out not only the knee joint, but also the places where muscles and ligaments attach to it:

We carry out longitudinal palmar stroking, without pressure.
Spiral rubbing is carried out using the fingertips in a circular motion with gentle pressure. Available with or without return. It is necessary to intensively but gently warm up the joint and tissues around it.
Spiral kneading, hands should move slowly, focusing inward.
Double circular kneading, changing tissue grip, minimal girth.
Effleurage, vibration technique, should be performed with gently relaxed hands.
We take the skin folds and pull them back slightly.
We finish stroking with the base of the palm.

Surgery

It is carried out during the progression of synovitis, in case of complications. The operation is performed through the Payre and Textor incision, joint revision and synovectomy (excision) are performed. It can be partial or, on the contrary, complete. Everything will depend on the degree of damage.

After surgery, antibacterial and hemostatic drugs are prescribed. It is necessary to ensure the leg rest; for this purpose, a Beler splint is most often used. Otherwise, synovitis may recur. You can load the knee joint 3–4 days after surgery.

Unconventional means

Hirudotherapy- an effective but non-traditional method of treating synovitis. It is advisable to use it only in combination with the main treatment.

We know that leeches inject a huge amount of useful enzymes into the blood, which improve the elasticity of the joint, thin the blood, improve blood circulation, and this allows us to achieve some improvements faster.

If your back, neck or lower back hurts, do not delay treatment unless you want to end up in a wheelchair! Chronic aching pain in the back, neck or lower back is the main sign of osteochondrosis, hernia or other serious disease. Treatment must begin right now...

Folk remedies at home

Folk remedies are used as supplements for the treatment of synovitis. With unexpressed synovitis or minor manifestations of symptoms, folk recipes can stop the course of the disease.

Preparation of ointment:

0.5 cups vegetable oil;
1 tsp. dead bees;
1 tsp. propolis;
1 tsp. beeswax.

Mix everything and place in a water bath for 20–30 minutes. Remove, stir, let cool and apply to the knee joint overnight, tying it with cotton cloth.

Compresses:

Pour 1 tbsp into a thermos. l. comfrey herb, pour a glass of boiling water, leave for 12–14 hours, strain. Soak a cloth in the solution and place it on the sore knee joint.
Take a clean cabbage leaf, crush it a little, apply it to the knee joint, secure it with a bandage, and insulate it on top. We keep it for a day, then replace it with a fresh one.
Squeeze beet juice moisten the cloth with it and apply it to the joint; no need to insulate it. Do it at night.

Bay leaf has an anti-inflammatory and analgesic effect and is used at home in the form of rubs and decoctions.

You can prepare a rub based on bay leaves:

2 tbsp. l. bay leaf (chopped).
1 cup oil (vegetable, corn).
Mix and leave for 7-8 days in a dark place.
Treat and use as a rub.

Laurel decoction:

Mix 10 g bay leaf, 300 ml water and boil for 3–5 minutes, wrap and let sit for 3–4 hours.
Then strain and drink it all at once before bed.
The healing properties disappear from storage, Therefore, you must always cook fresh.
Drink for 2 days, take a break for a week, 2 more days of admission. You can repeat it in a year.

Treatment of synovitis of the knee joint in children and adolescents

Treatment methods for synovitis in children and adolescents:

Carry out a puncture immobilization.
Apply symptomatic therapy: for infection - antibiotic drugs; for allergic nature - corticosteroids are indicated.
Sometimes surgery is indicated, but this is a last resort.
Physical therapy complex shown and exercise therapy.

Prevention

To prevent synovitis, you must:

Treat infectious and inflammatory diseases in a timely manner.
Avoid knee injuries, bruises, blows. If possible, use personal protective equipment.
Treat knee injuries fully and promptly and maintain a healthy lifestyle.
Daily, but moderate physical activity and gymnastics are recommended.
Include in your daily diet: gelatin-containing products, phytoncides, vitamins D and C.

Nutrition

The fundamental principles of treating synovitis include diet:

Gradual weight loss- this is a prerequisite for successful therapy. Losing weight reduces the stress on your joints.
Eat frequently 4-5 times a day, but in small portions, consume protein of animal or plant origin daily: meat, beans, lentils.
Carry out fasting days once a week- a diet in the form of fruits, vegetables, lactic acid products.
Normalize metabolic processes - exclude grape acids and easily digestible carbohydrates from the diet: chocolate, grapes, wine. Eat seafood, seaweed, plant foods, especially red and green vegetables.

Salt - of course, you don’t need to completely give it up, but reduce your consumption to 1 gram. per day is necessary.

Consequences and prognosis

If synovitis is treated untimely and incompetently, the consequences can be dire. For example, it will develop: periarthritis, gonarthrosis, phlegmon, purulent panarthritis or arthritis. Pus penetrates the joint capsule, bone rotting and sepsis begin. All this ultimately ends in disability and even death of the patient.

The prognosis in case of treatment of synovitis and compliance with all doctor’s instructions is quite favorable. Joint mobility is restored and relapses are extremely rare.

Synovitis of the knee joint and the army

If a young man was diagnosed with synovitis of the knee joint and underwent surgical treatment, then, according to Article 65, he should be assigned fitness category B. As a result, he will be released from military service and enlisted in the reserves.

A timely visit to a medical facility greatly increases your chances of curing synovitis and quickly returning to your previous life. Therefore, do not start the disease, and modern treatment methods will help you treat synovitis. They are quite effective, so the degree of relapse is minimal.

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