Synovitis of the shoulder joint
Synovitis of the shoulder joint - acute or chronic inflammation of the synovium, accompanied by the formation of exudate or effusion. May be infectious or aseptic. It occurs as a result of injuries, chronic degenerative-dystrophic joint diseases, endocrine disorders, allergic reactions, etc. It is manifested by swelling, pain, restriction of movements and an increase in the volume of the joint. Diagnosis is clarified by X-ray, arthropneumography, arthroscopy, CT, MRI, joint ultrasound and synovial fluid. Treatment is usually conservative.
Synovitis of the shoulder joint
Synovitis of the shoulder joint is an inflammatory process in the synovial( internal) shell of the joint. Accompanied by the accumulation of excess fluid. It is a reaction to intraarticular damage, irritation of the synovium by a damaged fragment of cartilage or bone, insufficiency of the ligamentous apparatus, impaired metabolic processes, the action of an infectious agent or allergen. It occurs less frequently than other synovitis( for example, synovitis of the knee joint).Treatment of this disease, depending on the underlying pathology that caused it, can be performed by traumatologists, orthopedists, rheumatologists, allergists and other specialists.
Classification and pathogenesis of synovitis of the shoulder joint
Synovitis may be aseptic or infectious. The most common aseptic synovitis is traumatic, followed by allergic, neurogenic, provoked by metabolic and endocrine disorders, etc., in the order of decreasing, etc. Aseptic synovitis may be acute or chronic along the course of the process, in the nature of effusion - serous, vinous-hemorrhagic or serous-fibrinoid( adhesive).For acute synovitis is characterized by serous inflammation with a pronounced vascular reaction of the synovial membrane.
In chronic synovitis, serous inflammation is rare, mixed forms predominate. Chronic serous-fibrinoid synovitis is accompanied by the formation of exudate rich in fibrin. Fibrin falls out in the form of clots and threads, which in the future are condensed and can form free intraarticular bodies. In chronic villous( villous or villezno-hemorrhagic) synovitis, sclerotized and hypertrophied villi of the inner shell are identified, which can be loosened and form chondromic bodies and rice bodies.
In acute forms of synovitis, the inner shell of the capsule does not change, with chronic fibrotic degeneration and this provokes the formation of a vicious circle. The pathologically altered synovial membrane poorly absorbs liquid, chronic recrudescence of the joint is formed, the accumulating fluid compresses the synovial membrane, stretches the capsule and ligaments, adversely affects blood and lymph circulation and provokes further degenerative-dystrophic changes in the joint.
Infectious synovitis usually proceeds acutely and is accompanied by the formation of purulent exudate. The cause of the development of this form of synovitis is contact, hematogenous or lymphogenous infection. When contact microbial insemination, pathogenic microorganisms penetrate into the joint from a graze, cut, torn or chipped wound, boil, abscess or phlegmon in the joint region. Hematogenous and lymphogenous infection can be observed in acute infectious diseases and purulent foci located in remote segments. With hematogenous spreading, microbes penetrate into the shoulder joint through the blood, while in the lymphogenous through the lymph.
Symptoms of synovitis of the shoulder joint
Patient suffering from acute aseptic synovitis, complains of moderate or weak pain and discomfort in the shoulder joint. The affected area is slightly edematous, the joint is enlarged in volume, the contours are smoothed. Sometimes there is an inconspicuous local hyperemia and hyperthermia. Movement is slightly limited. At palpation weak soreness is defined, at accumulation of a plenty of a liquid fluctuation is revealed. In the case of chronic aseptic synovitis, pain and edema are less pronounced, with a long course of symptoms dominated by secondary degenerative changes in the joint.
Acute purulent synovitis begins suddenly, develops within a few hours or days and is accompanied by a sharp pain, aggravated by the slightest movements. The joint is swollen, the shoulder is round, the bony projections are smoothed, the skin over the affected area is hot, hyperemic. Palpation is very painful. There are signs of general intoxication: fever, weakness, weakness, nausea, chills and headache. In the blood, inflammatory changes are revealed.
Diagnostics and treatment of synovitis of the shoulder joint
The most informative studies that allow to determine the cause and nature of inflammation are a medical-diagnostic puncture followed by puncture examination, synovial biopsy, radiography, arthropneumography, ultrasound of the shoulder joint, CT of the joint and MRI of the shoulder joint. If necessary, use arthroscopy - a medical diagnostic method that allows you to assess changes in the joint by direct visual inspection using special equipment. When suspected of allergic reactions, endocrine and metabolic disorders prescribe consultations of an allergist, endocrinologist and other specialists.
Treatment of synovitis is usually conservative. The patient is recommended to rest, if necessary, immobilize using a bandage bandage. When a large amount of fluid accumulates, the joint is punctured. Prescribe analgesics and NSAIDs, with infectious synovitis apply antibiotics. In a chronic aseptic process, metabolic disorders are corrected using inhibitors of proteolytic enzymes( hyaluronidase, proteinase, lysozyme) and stabilizers of lysosome membranes( contrikal, trazylol).
Patients are referred to physiotherapeutic procedures: phonophoresis with corticosteroid drugs, UHF, magnetotherapy, electrophoresis with lazonil, heparin and contrial. In the recovery period, exercise therapy is performed. Surgical intervention is indicated with prolonged flow of chronic synovitis, inefficiency of conservative therapy and the presence of irreversible changes in the synovial membrane. Depending on the prevalence and severity of the process, a total, subtotal or partial synovectomy of the shoulder joint is performed. In the postoperative period prescribe antibiotics, physiotherapy, exercise therapy and massage.
How to treat pain and swelling in the shoulder
Among diseases of the shoulder joint in the practice of orthopedists and traumatologists, one sometimes has to deal with synovitis - an inflammation of the synovial membrane lining the inside of the joint bag. It is the synovitis of the shoulder joint that can give frightening edema and pain. What can lead to it?
Causes of synovitis of the shoulder joint
Inflammations of the soft tissues of the joint are most often the result of:
- acute rheumatic fever;
- of osteoarthritis;
- of neighboring inflammatory processes;
- infectious diseases( more often staphylococcal or streptococcal);
- tuberculosis, syphilis, gonorrhea.
Among other more rare causes - exposure to allergens, toxic substances, metabolic and hormonal disorders, neurogenic diseases.
Deforming dorsopathies can also contribute to synovitis of the shoulder joint:
- scoliosis, kyphosis( stoop), kyphoscoliosis.
The shoulder is characterized by traumatic injuries during the fall, with sweeping, often repetitive movements:
- , for example, volleyball players, basketball players, throwers of the core, and other athletes with similar dynamics of movements.
With prolonged position with raised hands, there is a fatigue tension in the muscles of the shoulder joint, transmitted to other tissues. On this basis, people whose activities are associated with work that requires constant lifting of hands can also develop chronic inflammation in the shoulder joint:
- painters, plasterers, ceiling installers, etc.
The nature of the lesion with synovitis of the shoulder
Most often this is a one-sided lesion. However, with certain diseases( rheumatoid or infectious arthritis, acute rheumatism), bilateral inflammation of the synovial membranes of the shoulder is also possible.
At the same time, there may be inflammation of other small and medium joints( knee, wrist, elbow, ankle).
Types and stages of synovitis
The synovitis of the shoulder joint can be of the type:
- serous or purulent
The course of the disease can be divided into three main stages:
The structure of the shoulder joint: the figure shows the synovial membrane lining the capsule. It is her inflammation that leads to excessive effusion in the synovial cavity, pain and swelling of the joint.
- The first stage( primary reaction):
- In the synovial membrane there is a slight reactive irritation and hyperemia.
- Swelling and excretion of synovium( synovial fluid) is insignificant.
- Second stage( serous):
- If the action of the stimulus( traumatic, infectious and other effects) does not stop, then the reactive stimulation passes into the serous form - a serous effusion is formed.
- The synovial membrane becomes full-blooded and sharply edematous, and its surface looks velvety, with enlarged villi.
- Intracavitary exudate - yellow with clots of fibrin.
- Microscopic examination of the synovial membrane and of the subsidonovial tissue shows small-cell infiltration and proliferation( division) of synovial cells.
- Third stage( purulent):
- With the progression of the process of the phenomenon of hyperemia( fullness with blood vessels) increases.
- The synovial membrane is even more thickened and impregnated with purulent bodies and purulent sticks.
- In exudate, fibrin flakes are mixed with pus.
- Chronic purulent synovitis gradually changes to joint tissue and bone.
- Acute purulent synovitis is fraught with sepsis - this is the most dangerous form of it.
Symptoms of synovitis of the shoulder joint
- The main symptom of the disease is the flow of the shoulder in the area of the clavicle and deltoid muscle:
- the bones joints are not probed, the shoulder becomes round
- Simple movements, heavy weights begin to cause pain.
- The patient holds his arm in a half-bent state, pushing it slightly forward: the feeling that the forearm is in the sling.
- In posttraumatic synovitis, the temperature may be normal or slightly elevated.
Symptoms of acute synovitis
- Acute serous synovitis is characterized by severe soreness in movements and palpation. Pain can be delivered to the neck or arm.
- In acute form, there is an increase in temperature( with a purulent synovitis - above 38˚C).
- The skin of the shoulder surface turns red.
- In the future, the inflammation can spread to neighboring tissues and proceed in the form of parosynovitis.
- Joint tissues swell and become dough-like and glossy in appearance.
Chronic synovitis of the shoulder joint
Chronic synovitis develops for the following reasons:
- The constant source of irritation has not been eliminated, and the disease continuously recurs.
- Has not been performed as should a puncture.
- There was no complete absorption of exudate due to the fact that the joint was not immobilized and the patient did not observe rest.
An independent disease is not a chronic synovitis - this is the result of neglected and unresolved problems.
Symptoms of chronic synovitis of the shoulder
- With this form there are no sharply expressed symptoms of pain or swelling due to the fact that the fluid no longer overflows the joint cavity.
- Only a slight swelling of the shoulder can be observed.
- The synovium is thickened due to fibrous degeneration.
- Patients complain of rapid fatigue and a feeling of heaviness in the shoulder joint.
- In the future, looseness of the shoulder and limited movements develop.
Diagnosis of shoulder synovitis
For all acute shoulder pain accompanied by swelling, you need to visit a traumatologist or orthopedist.
Clinical external examination and collection of information on previous events and illnesses may be sufficient to make a diagnosis. Otherwise, the doctor will conduct additional tests:
- radiography or MRI;
- laboratory diagnostics with blood, urine and synovia analyzes.
The composition and color of the exudate represents an important diagnostic value of :
- murky color, for example, and the presence of leukocytes can talk about the rheumatic origin of synovitis;
- an abundance of protein - about rheumatoid arthritis;
- the presence of pus in the exudate indicates a purulent form of synovitis.
Treatment of synovitis of the shoulder joint
Serous synovitis of the shoulder joint often does not require treatment:
- It is enough to apply a tight bandage and restrict movement.
- After several days of rest, exudate can be absorbed into the synovial membrane, and the puffiness and pain pass.
- With excess effusion, puncture is performed and the cavity is released from the liquid.
- If abnormal purulent, purulent cavity is necessary to open and remove its contents by puncture or cutting the joint with drainage.
Surgery for shoulder synovitis is rare.
With purulent parosynovitis, a wide excision of the synovium with deep drainage is required, as this complication can lead to wrinkling and scarring of the connective tissues and a decrease in the functionality of the shoulder joint.
In severe, non-conservative cases, the synovial membrane is completely removed.
After operation, the shoulder must be immobilized by overlapping the tire.
What medications are needed for
- Drug treatment is aimed at reducing the symptoms of pain and inflammation with NSAIDs( diclofenac, ketoprofen, ibuprofen, etc.).
- In rare cases, with an acute synovitis accompanied by a dropsy and adjacent tissues, hydrocortisone, dexamethasone and similar corticosteroids are injected.
- Purulent forms of synovitis require treatment with antibiotics and antiseptics. Antibiotic is prescribed according to the results of bacteriological analysis of synovia: this analysis is extremely important in the treatment of chronic forms of synovitis.
Physiotherapy with synovitis of the shoulder joint
Physiotherapy has a multifaceted effect:
- analgesic and anti-inflammatory;
- stimulating blood and lymph flow;
- has a beneficial effect on the nervous system.
With synovitis of the shoulder are effective:
- therapeutic mud;
- UHT, etc.
Prevention of synovitis of the shoulder
Synovitis is prevented through emergency relief of inflammatory processes in the joints and treatment of the main causes of synovitis - trauma, arthrosis, infectious diseases.
Do not postpone visiting a doctor in a "long box", much less try to eradicate the problem.
Such a disease, as a synovitis of the shoulder joint, usually has a favorable prognosis:
Recovery occurs about two weeks later, and as many as necessary for a complete recovery.
However, improper treatment( usually in the form of self-medication) causes the disease to become chronic, and this is a completely different story.(с)
Video: Treatment of pain in the shoulder.
Synovitis is an inflammation of the synovium, which is limited by its limits and is characterized by an accumulation of inflammatory effusion in the cavity lined with this membrane.
A synovial sac( a small flattened cavity lined with a synovial membrane, delimited from the surrounding tissues by a capsule and filled with synovial fluid), a synovial vagina of a tendon, articular cavities can serve as lining the synovial membrane of the cavities involved in this inflammatory process. Often occurs( knee, elbow, ankle, wrist).These processes are characterized by the lesion of one joint, rarely - several at the same time.
ICD code 10
Here are excluded: chronic crepitating wrist and wrist inflammation( M70.0) current trauma - ligament or tendon injuries in areas of the body of soft tissue disease associated with load, overload and pressure( M70.0)
- M65.0 Thisabbreviation of tendon sheath abscess. If necessary, an additional code( B95-B96) is used to identify the bacterial agent.
- M65.1 Means other infectious( teno) inflammations. M65.2 Calcific tendonitis. At the same time, tendonitis of the shoulder( M75.3) and refined tendinitis( M75-M77) are completely excluded.
- M65.3 Represents a snapping finger. Nodular sinus disease. M65.4 Tenosynovitis of the styloid process of the radial bone [de Kerven's syndrome]
- M65.8 Other inflammations and tenosynovitis. M65.9 Synovitis and tenosynovitis, unspecified. All these codes show the location of the disease and its types. Synovitis is a serious disease that requires a full trial. Thanks to the localization code, you can understand the seriousness of the phenomenon and prescribe a quality treatment.
What is the danger of synovitis?
Do you know how dangerous the synovitis is? It is definitely difficult to answer this question. Because much depends on the location of the disease. So, the suppuration of the knee joint is dangerous because of its location. The fact is that when moving a person takes all the load on the knee.
If any kind of injury occurs, inflammation may occur. It is simple to detect that the knee joint is inflamed. The first symptomatology manifests itself on the second day. Initially, there is a pain syndrome. It is not sharp at all, but looks like a aching and prolonged one. When diagnosing the main thing is not to make a mistake and not confuse it with another disorder.
Unpleasant sensations may be accompanied by fever and redness in the area of inflammation. The diagnosis is made exclusively by the attending physician. In general, the ailment is not dangerous if it is immediately treated. Therefore, the main danger lies in the neglect of the disease. If you diagnose it and start fixing it in time, there will be no problems.
Causes of synovitis
Causes of synovitis may depend on other diseases or directly from a diarrhea injury. Most often, it manifests itself in diseases that are metabolic in nature or associated with autoimmune nature. If it occurs against the background of other diseases of the knee joint, then it is secondary. In this case, it can be defined as a reactive suppuration.
Inflammation of the joint during propervation is usually not accompanied by infection. Simply put, it is aseptic. If there is infection of the synovial bag with various harmful agents, the liquid changes its composition. In this case, pathogenic microorganisms are actively prevailing in the lesion site, which cause inflammation of a different kind, which leads to complications.
Synovitis after operation
Synovitis after the operation "behaves" normally. But it is desirable to monitor the patient's condition. After all, serious complications in the form of arthritis are not ruled out. It is possible to reduce the volume of movements due to irreversible changes in the synovial membrane or articular surfaces. There is also a spreading of the process to neighboring parts of the ligamentous apparatus.
The most serious complication of the infectious form of inflammation is sepsis, which is life-threatening. Sepsis( the appearance of a pathogen in the blood) with an infectious synovitis may develop in people with a weakened immune system( eg, with HIV infection) or in the event of a prolonged absence of treatment.
In any case, a person for a long time should be under the supervision of a specialist. Because relapses occur quite often and avoid them in many cases is not so simple.
Infectious synovitis is usually caused by pathogens that cause inflammation of a nonspecific type. It can be the following pathogens: staphylo-, strepto- and pneumococci. There is a specific type. These include microbacteria tuberculosis.
Pathogenic microorganisms are able to penetrate into the joint with injuries and wounds( contact path), or be carried with lymph and blood from internal foci of infection( lymphogenous and hematogenous pathways).This mechanism of the disease is often found in people who suffer from arthritis and allergic diseases, as well as hemophilia.
It should be noted immediately that getting rid of this type of disease is not so simple. After all, it occurs against the background of infection in the inflamed area. This process is easier to prevent, in time turning for help to a doctor. It is eliminated medically, but it requires qualitative treatment. After all, repeated forms of the disease are possible.
Is a form of the disease. It arises hematogenously in the form of a rash of tubercles on the synovial membrane. Clinically, such primary arthritis, in spite of their duration, proceeds in most cases in good order. In most cases, an effusion with thickening of the capsule is formed. But together they do not lead to a curdled regeneration, do not cause destructive changes in cartilages or bones, and often end in the usual sanatorium-orthopedic treatment by restoration of the function of a joint with complete mobility. In the period of onset and initial development, the primary synovial lesions at the knee joint are very similar in appearance to those observed in primary ostites. As for non-specific reactive changes, they differ from them mainly by their constancy. In this respect, they are closer to the early manifestations of the secondary synovitis, characterized by a triad - pain, muscle atrophy and some restriction of function, but with a more pronounced effusion and thickening of the capsule in the absence of contractures and with considerable safety of movements.
Allergic synovitis is a form of disease of a reactive form. Many patients in the formulation of such a diagnosis come in complete bewilderment. After all, not many understand why they developed inflammation of this type.
This form of pathology develops due to toxic or mechanical effects. A variety of allergic reactions are typical for this type of inflammation.
Without specific morphological changes, this species is distinguished by a lighter, usually cyclic, flow. It is observed more often after infection, during recovery from a usually mild acute infection. The trigger can serve as an angina or the cessation of an acute period in dysentery. This type of inflammation is of particular interest in infectious disease. After all, in its manifestation, it resembles a rare form. To date, there are no exact causes of the onset of the disease.
Traumatic synovitis occurs quite often, especially in athletes. In case of acute manifestation of the disease, an increase in the volume of the compound is observed for several hours. For this type of disease is characterized by a change in the form of diarthrosis, the smoothness of its contours, and an increase in temperature. There is a possible pain on palpation. In addition, the articular cavity produces an effusion, which is especially well revealed in the knee joint by balloting the patella. Movement in the connection is limited, painful. Weakness, malaise, a moderate increase in body temperature, acceleration of the ROE are noted.
With a purulent form of the disease, the symptoms are more pronounced than with serous. Characterized by the severe general condition of the patient. The contours of diarthrosis are significantly smoothened, reddening of the skin in the joint area, soreness, restriction of movements, contracture. Often in the diagnosis of the phenomenon of regional lymphadenitis. In some cases, the disease extends to the fibrous membrane of the joint capsule with the development of purulent arthritis and surrounding tissue. The area of diarthrosis is significantly increased, the tissues are pasty, the skin on the joints is sharply hyperemic, glossy. If the bones, cartilage and connective apparatus of the joint are involved in the inflammatory process, panarthritis develops. An untreated malaise can recur. Often recurrent suppuration is accompanied by chronic forms of dropsy. They are characterized by further development of hypotrophy and its fibrosis. A vicious circle is formed, aggravating the phenomenon and development of degenerative-dystrophic processes in diarrhea.
Post-traumatic synovitis occurs most often. This reaction of the body to the destruction of the tissues of diarthrosis or its damage. The synovial membrane in this case forms an effusion into the joint. It can also arise without visible damage outside the connection. This occurs in case of irritation of the shell as a result of movements of the joint body, damage to the cartilage or meniscus.
Diagnosis of the disease is as follows. To determine the exact problem and the cause of the inflammatory process of the synovial membrane, it is necessary to find out whether the patient had a trauma preceded by inflammation or an inflammatory disease. After all, this will make it possible to distinguish rheumatoid arthritis from post-traumatic arthritis.
The acute form of the disease is characterized by an increase in diarrtosis in a volume lasting from several hours to several days. There is a change in shape, swelling of the knee, smoothness of the contours of the injured and a rise in temperature in the joint region, painful sensations during palpation. The mobility of the joint is considerably limited, and the slightest movement causes acute pain. In this case, there is general weakness, an increase in body temperature, malaise and a blood test shows an acceleration of the ROE.
Symptoms of synovitis
Symptoms of synovitis depend on the variety of the disease. In acute serous nonspecific form, a change in the shape of the joint is observed, its contours are smoothed out. An increase in body temperature is noted, pain is possible when the joint is felt, and an effusion begins to accumulate in the joint cavity. This phenomenon is especially well seen in the knee diarrhea, as it is manifested by the so-called symptom of patellar balloting. For him, the characteristic is the following: with a straightened leg pressing on the patella leads to its immersion in the joint cavity until it stops in the bone, but after stopping the pressure the patella appears to "float up".It is not impossible to limit and painful movements in the joint, as well as general weakness, malaise.
In acute purulent inflammation, the symptoms of the disease are much more severe than in the serous form. For a purulent appearance, the patient's condition is severe. It is expressed in a sharp general weakness, chills, high body temperature, sometimes - in the appearance of delirium. Often the smoothness of the contours of affected diarrtosis, reddening of the skin above it, soreness and restriction of movements in it is determined. Sometimes his contracture occurs. Suppurative delivery can be accompanied by regional lymphadenitis. If this malaise is not cured, a relapse is not excluded.
The initial period of chronic serous suppuration is characterized by mild symptomatology. Patients complain of the rapid fatigue that occurs when walking fatigue. All this can be accompanied by restriction of movements in the affected joint, the appearance of aching pain. Gradually there is an accumulation in the joint cavity of an abundant amount of effusion. This phenomenon leads to the development of hydratrosis( dropsy compound).If edema on a diartose exists for a long period, it is possible that it will not be whipped.
Synovitis of the knee joint
Synovitis of the knee joint can be varied. The causes of this phenomenon are hidden in many ways. Inflammation of the synovial membrane develops against a background of metabolic and autoimmune diseases, for example, arthritis, bursitis, hemophilia. Also, the inflammation of the knee joint is able to "form" without visible external damage as a result of cartilage trauma, a meniscus or a lack of binding fluid in the knee joint.
Prevention, the symptoms of which usually appear gradually, are protracted. Often, symptoms appear 2-3 days after infection. The fluid accumulated in diarrhea leads to deformation of the joint and restriction of movement. The skin around the knee joint is not inflamed, the temperature is normal. The victim feels pain, not very strong, but, in the main, pulling and prolonged.
When inflammation of the knee diarrtosa is very important to put the correct diagnosis, not only to determine the disorder itself, but also to find out the reason, as a result of which it happened. After all, in case of any mistake, a relapse is possible. For accurate diagnosis, the puncture of the knee joint is performed. The surgeon slowly introduces a special needle into the joint cavity and gently selects a little fluid, which is then sent for analysis. The obtained "raw materials" determine the level of blood cells, the amount of protein and the presence of harmful microorganisms. In most cases, the magnetic resonance method and the method of arthroscopy are used, which allow to determine the appearance of diarthrosis, as well as the state of cartilage and diagnose synovitis.
Synovitis of the hip joint
Synovitis of the hip joint is an inflammation of its synovial membrane with the formation of a so-called effusion. It should be noted that inflammation can develop on several joints. The disorder in this case is called chasing, and occurs much more often.
Nonspecific form often causes lameness in children, most often they suffer from boys from 3 to 10 years. An ailment may appear after an acute respiratory viral infection or some kind of trauma, but the exact cause-and-effect relationship has not been proven yet. If the cause of the development is the infection from internal foci, then this is evidence of the presence of an infectious suppuration, if through trauma - traumatic. Most often, the disease manifests itself spontaneously and develops quickly enough. Inflammation of the synovial membrane leads to the accumulation of fluid, resulting in a tumor of the compound.
Symptoms of inflammation can resemble the symptoms of tuberculosis. This is manifested in the limitation of the mobility of diarthrosis, spasm in muscles and pain sensations. A feverish condition is observed in rare cases, as does a rise in temperature. X-ray examination can show nothing at the early stages of the disease. The only thing that attracts attention is the enlargement of the joint space.
Gradually, night pains become an indicator that the pathology of the joint has begun an active phase of development. The danger of this disease is that it causes unsharp pain, which can be safely endured for quite a long time, especially as it decreases at rest. Ultimately, patients are treated late for help, and treatment in this case is difficult, because the ailment is not easily eliminated.
Synovitis of the ankle
Synovitis of the ankle in its shape can be aseptic or infectious. Infectious variation develops due to the penetration into the synovial bag of an infectious agent of any type. The main causes of the aseptic type include: trauma, hormonal disorders, allergic conditions, neurogenic factors,
Inflammation of the ankle, accompanied by increased soreness in palpation in the joint projection. If the pathological process in the affected area begins to develop, swelling and effusion immediately appears, and as a result, hyperemia is observed. Patients mainly complain of a violation of the joint functions, they have an increase in body temperature, the volume of movements is limited.
It should be emphasized that the synovitis of this type, as a rule, develops only in one diarthrosis and does not spread simultaneously to several. Bilateral lesion in clinical practice is very rare. But nevertheless, such cases were encountered.
Synovitis of the shoulder joint
The synovitis of the shoulder joint is an inflammatory process that forms in the synovial membrane of the joint. It is also characterized by the accumulation of liquid. The disease, the symptomatology of which is described in this article, in most cases occurs due to mechanical trauma, infection or arthritis.
Symptoms of propping. Basically, they depend on the type of disease. During acute traumatic form, the volume of the joint and its shape increase. Also, the affected person can have an increase in body temperature, limited movement of diarthrosis, general weakness. Purulent inflammation often has such symptoms: severe weakness, chills, delirium, high body temperature. In some cases, redness of the skin in the area of the affected joint, restriction of movements is observed. Recurrent decay is characterized by the appearance of chronic dropsy.
To determine the type of the disease, seek medical advice immediately if you have any symptoms. In more advanced cases, the ailment is not so easy to cure.
Synovitis wrist joint
Synovitis wrist joint is not so common. But at the same time it must be diagnosed immediately. The first thing is an MRI.Thanks to it, the structure of the distal ray-fibrous joint, mid-wrinkle, inter-wrist and carpometacarpal joints is evaluated. All these joints are interconnected functionally, and represent a single carpal diarthrosis. Optimal diagnosis of structural changes in the bones that form these joints is achieved when performing magnetic resonance imaging.
Magnetic resonance imaging of the area of the wrist joint is mainly shown to all patients with trauma, pain in diarthrosis, impaired function and mobility restriction. The results of MRI can provide the doctor with the most complete information about the condition of the bones forming the wrist joint, ligaments, tendons, joint disc and ligaments that make up the trihedral fibrotic cartilage complex, as well as the ulnar nerve.
Magnetic resonance imaging helps to identify the suppuration of the wrist and hand joints, as well as to fully assess the condition of the synovium and the presence of pannums with suspicion of arthritis of various etiologies. Mainly, the cause of chronic pain and impaired function in carpal diarthrosis are pararticular ganglion cysts and tenosynovitis of tendons. They arise as a result of chronic stressful stress in people whose activity is associated with small manual labor. When MRI is performed, it is possible to reliably determine the localization, size of the cyst, evaluate its contents, connect the cyst with the joint or synovium of the tendon, which is important in the planning of synovitis therapy.
Synovitis of the brush
For the synovitis of the brush is characterized by a gradual onset and slow progression. The disorder begins to manifest itself with periodically arising swelling in the joint. As a rule, this is due to the accumulation of hemorrhagic exudate in its cavity. During the load on the affected diarthrosis, because of the infringement of the outgrowths of the synovial membrane, the occurrence of pain is not excluded. Over time, swelling in the joint and arthralgia becomes permanent.
Movement in the joint for a long period remain in full, then gradually there is and stiffness increases. In special cases, there are periodic "blockade" of diarrtosis, indicating the presence of "articular mouse".A person can not move the brush freely.
The defeat of the synovium of the mucous bags has the symptoms of bursitis and is most common in the ankle. Involving the synovial membrane of the tendon sheath leads to the development of serious tendovaginitis and is usually observed in the tendons of the flexor and extensor of the hand. The general condition of patients, as a rule, is not violated. The body temperature is normal.
Reactive synovitis may cause an allergy. Doctors do their best to eliminate the damaged functions of the affected joint. For this, special general restorative therapy is actively used, as well as physiotherapy and physiotherapy. The actions of physicians, mainly aimed not only at eliminating the cause, but also in relieving the symptoms of the disease. After all, mainly the function and pain are manifested.
To remove strong pain, various drugs are used. Sometimes, in order to cope with this serious illness, the patient has to operate the affected joint. It should be noted that surgical intervention remains an extreme measure. It is used only if there is no effect of conservative treatment or a threat to the health of the patient( development of sepsis).
If a person has noticed any signs of propping. You should immediately seek help from a specialist. Symptoms are as follows: pain, severe mobility limitations, fever, and changes in the form of diarthrosis. The approach to the treatment of patients, as a rule, is complex, it is determined by the causes that provoked this malaise, and by the mechanism of the development of the pathological process.
Acute synovitis appears quite often. The disease is characterized by excessive accumulation of fluid in the joint. In children, inflammation often develops due to injuries. Also, the ailment can occur against the background of inflammatory and infectious diseases, such as rheumatism, tuberculosis, syphilis and others.
With genetic predisposition, as well as against the background of existing neuroendocrine disorders, inflammation can develop with any toxic effect on the body. It can even be an ordinary flu. In this case we are talking about, so-called, reactive inflammation.
Acute suppuration often develops when the infection is infectious or traumatic. In case of trauma, there is a violation of the integrity of the joint cavity, as a result of which the inflammatory process develops. Often the cause of such inflammation is the lack of ligament apparatus.
As a rule, one diarrtosis suffers with lesions, but there are cases when the disease spreads to several joints. The most common inflammation of the knee joint, because it is subject to heavy loads and injuries.
A characteristic symptom of the acute form is the severe pain of affected diarrhea. When palpation pain is greatly increased. For this form of inflammation is characterized by an increase in the joint in the volume for several hours or days. In his cavity an effusion is formed, which can easily be determined by balloting the patella. The shape of the joint is observed, the shape of the joint changes, and the contours of its contours are noted. The movement of diarrtosis is severely limited. The patient may have general symptoms: malaise, weakness, fever, and high rates of ESR.
Chronic synovitis is relatively rare. At the initial stage, clinical manifestations are poorly expressed. Patients complain of rapid fatigue, fatigue when walking. It is not ruled out that there is a slight restriction of movements in the joint and the presence of aching pains. In the articular cavity, the effusion begins to accumulate abundantly, as a result of which hydrocephalus develops. With the prolonged existence of which there is a stretching of the ligaments of the joint. This process leads to its looseness, subluxation and even dislocation. In many cases, mixed types are observed: chronic serous-fibrinoid, chronic viral and viral haemorrhagic.
In chronic serous-fibrinoid stagnation or serous fibrous suppuration in abundant efflorescence, much fibrin is observed, which has fallen out as separate filaments and clots. They are actively condensed and thus form free intraarticular bodies.
For chronic villous adherence, the presence of hypertrophied and sclerotized villi is characteristic. They are able to loosen up with the formation of so-called rice bodies and chondromic bodies. In the chronic form of synovitis, the increase in pathological changes and clinical manifestations of the disease is caused not so much by the duration of the inflammatory process as by the violation of blood and lymph circulation in the diarrtosis capsule as a result of its fibrous degeneration.
Minimal synovitis is characterized by intense unpleasant sensations and swelling of the affected area. This form is characterized by a change in the joint due to the accumulation of serous fluid in its cavity. The mobility of the organ is significantly reduced, the ligamentous apparatus is weakened, and the cartilage is unstable. If, on the basis of the examination, the minimal support was diagnosed, then it is sufficient to use a pressure bandage or a special patella.
In the infectious nature of the disease, local symptoms of inflammation are observed. This increase in the size of affected tissues and increase in local body temperature. In acute form, serous fluid accumulates. If you do not start treatment for a long time, purulent corpuscles may appear in it. In this case, the ends of bones will be involved in the process. Over time, there will be signs of general intoxication: high fever, chills, pain, weakness.
Connective tissue in the purulent nature of the inflammation significantly wrinkles, and it forms scars. In the future, as a result of changes, there is a violation of the mobility of the connection. In children aged 3-8 years, transient rotting of femoral diarrtosis is usually diagnosed. This inflammation of the cartilage passes quickly, but arises from a viral infection, being the most common cause of sheer lameness in children of this age.
Moderate synovitis often accompanies OA, especially in later stages and may contribute to increased pain. In favor of this mechanism is evidence of a reduction in pain with OA in response to the treatment of NSAIDs.
. Pain, which was caused by inflammation, has long been the subject of serious attention, and at present the mechanisms of pain associated with inflammation are being actively studied. The fact is that any peripheral pain is associated with an increase in the sensitivity of specialized neurons - nociceptors. They are capable of creating a signal that is recognizable as pain. Increasing the sensitivity of the primary nociceptor in the affected peripheral tissue can lead to an increase in the activity of neurons that send a signal to the spinal cord and the central nervous system, but it must be emphasized that spontaneous electrical activity that causes a persistent pain syndrome can be generated in the inflammatory focus.
The following pro-inflammatory components are a powerful inducer of pain sensitivity: bradykinins, histamine, neurokinins, complement, nitric oxide, which are usually found in the inflammatory focus. Particular attention is paid to prostaglandins, the accumulation of which correlates with the intensity of inflammation and hyperalgesia.
Violation of biomechanics in the affected joint can lead to the development of secondary periarticular syndromes - bursitis, tenosynovitis, etc. When collecting an anamnesis and examining a patient with OA, it is necessary to determine what causes the pain - directly affection of the joint or inflammation localized in joint bags and synovial vaginas. Based on this, it is decided how to eliminate the synovitis.
The pronounced synovitis manifests itself with sharper symptoms. A person suffering from this kind of inflammation is concerned about the severity and pain in the field of diarthrosis. With a minor lesion, the pain syndrome is weak and appears mainly during movements. In severe form, the patient complains of pain and a feeling of bursting even at rest. Movement is significantly limited. When examined, not a sharp swelling of soft tissues, smoothing out contours and increasing the size of the joint is revealed. There may be a slight redness and an increase in local temperature. When palpation is determined by fluctuation.
To confirm the diagnosis and clarify the cause of inflammation, a puncture is performed with subsequent cytological and microscopic examination of the synovial fluid. According to the patient's testimony, they are often referred for consultations to various specialists. Basically it is: rheumatologist, phthisiatrist, endocrinologist and allergist. If necessary, appoint additional studies: x-ray of ankle diarrtosis, ultrasound, CT of the joint and MRI of the ankle joint, allergic tests, blood testing for immunoglobulins and C-reactive protein, etc.
Villonodular synovitis is not a malignant malaise. It is characterized by the proliferation of synovia, pigmentation with hemosiderin, the formation of nodular masses, villi, pannus. The disorder is rare, more common at a young age.
Symptomatology. PVA can be suspected in the presence of chronic propping in one diarthrosis. In general, the knee joint is inflamed, other connections are extremely rare. Over the years, edema of diarrtosis is gradually increasing, moderate pains are observed( severe pain, usually associated with trauma).There is a defoguration of the joint, in the period of exacerbation - effusion, soreness, local hyperthermia, limitation of mobility. At a roentgenography quite often changes are not found out. In extremely rare cases, degenerative changes with osteoporosis, which resemble surface erosion, are revealed.
At a laboratory examination during an exacerbation of the disease, an increase in ESR is possible. The synovial fluid is xanthochromic with an admixture of blood. The diagnosis of PVS can be made on the basis of synovial sheath biopsy: nodal proliferation, hemosiderosis, infiltration by mononuclear cells are characteristic.
Treatment. Synovectomy is indicated only when the compound is severely affected, since recurrence occurs in 30% of cases. In general, synovitis is eliminated medically.
Suprapatellar synovitis occurs against the background of advanced bursitis. Symptoms begin to manifest themselves, on the first-second days after the injury. This happens in the case when the liquid accumulates in the tissues in sufficient quantity and deforms it. This entails difficulties in making movements. If the time is not taken, the inflammation of the consequences for themselves will not be the most pleasant. Therefore, for a certain symptomatology, it is necessary to diagnose correctly.
For injured people, the signs of the disease are very insidious. This can lead to unpleasant consequences in the form of misdiagnosed diagnosis. Detection is complicated by the fact that the ailment of knee diarrtosis symptoms is similar to similar injuries. When the disease is completely absent as the inflammation of the skin, and the local elevated temperature. However, in order to make sure of the diagnosis definitively, they can perform a joint puncture. In the connection cavity, a needle is inserted to take the liquid and checked for the presence of certain blood cells.
Transient synovitis of hip dysarthrosis( TC CD) is a disease that often occurs in children 2 to 15 years of age. TC has recently taken an important place among other diseases of the musculoskeletal system, its frequency is 5.2 per 10 thousand of the children's population, so it is very important to start taking drugs from an early age.
The causes of inflammation, unfortunately, are not exactly established. There are conflicting views on the etiology and pathogenesis of TS CS in children, there are no strategic directions for the prevention and therapy of this disease. Most likely, the inflammation of the synovial capsule of the joint has a toxic-allergic origin. In order to exclude this disease, it is necessary to take special measures for prevention.
The disorder can have an acute, subacute and sometimes gradual onset. The defeat of the joint is also manifested by pain in the groin, knee diarrtosis, along the thigh characteristic lameness, restriction and soreness in movements in the hip joint. In 5% of cases, two CS are affected.
The provoking factor for the development of the TC is often any infection, usually respiratory, which the child was sick for 2-4 weeks before.
Exudative synovitis develops most often with prolonged microtraumatism, in people whose work is associated with prolonged pressure on the elbow: engravers, scrofulers, miners. The fact that the elbow joint is very reactive - even with a minor injury corresponds to excessive formation of scar tissue and ossifits. Preventing the occurrence of bursitis reduces to a decrease in pressure on the elbow process.
During the development of the pathological process may be accompanied by effusion of serous, hemorrhagic or purulent nature, cellular proliferation, fibrosis, and sometimes - calcification of necrotic tissues. Separately, the disease is extremely rare, it is often combined with damage to other soft-tissue structures. In most cases there is a simultaneous or sequential involvement in the pathological process of tendons that touch inflamed articular bags - tendobursita.
Place of localization is inflammation - superficial. Mostly between the bony protuberances and the skin. Synovitis of this type belongs to the first group, since it is located between the skin and the elbow process.
Serous synovitis is an inflammation of the synovial capsule of the joint. Often occurs due to injury, overfatigue of the animal due to early exploitation, acute rheumatism, brucellosis and other diseases. Basic clinical signs. The inflammatory process is rapidly developing. This leads to a sharp hyperemia and swelling of the synovial membrane. Synovial villi, especially near the articular margin, are sharply hyperemic, swollen. The fibrous membrane of the diarrtosa capsule is significantly impregnated with a serous effusion. In the cavity of the joint begins to accumulate effusion, sometimes turbid, containing small-molecule proteins. In the synovial fluid, the number of leukocytes increases, and the content of erythrocytes also increases significantly. In the subsequent to the effusion, the sloughing endothelial cells of the synovial membrane are mixed.
If the process is significantly delayed, then sweat fibrin is observed. As for infiltration, at first it is significantly limited, then acquires a diffuse character. Paraarticular tissues become edematous.
Insect-like synovitis is a kind of fibrogistic cell proliferation. At the same time, formation of numerous fork-lined structures takes place. All of them have local growth. Women suffer from this inflammation twice as often as men. In 80% of cases the knee joint suffers, others, mainly large ones, are affected less often. Occasionally a multiple process develops. Approximately a quarter of affected patients have numerous cysts in the bone around the patient with diarrhea.
The cyst is myxoid material or liquid. Sometimes in the affected joint there are small areas of apparently unchanged synovial membrane. The nasal outgrowths of this membrane vary both in size and shape. In addition to these, massive nodules without or similar to naps can take place. There are also erosions of articular cartilage. Under a microscope, the villi are covered with synoviocytes, which contain hemosideric in abundance. The fibers of the villi are densely permeated with an inflammatory infiltrate.
Hemosiderin can occur in the cytoplasm of macrophages and outside cells. In some cases macrophages with a foamy cytoplasm and giant multinucleate cells are found. Lymphocytes are usually few. The shapes of mitosis can be found both in synoviocytes and in cells of the inflammatory infiltrate. A certain part of the villi can be sclerized, and occasional whole foci of fibrosis are formed. Pigmented villous-nodular synovitis should be differentiated from traumatic or rheumatic fever, hemarthrosis and synovial sarcoma.
Secondary synovitis occurs in patients suffering from osteoarthritis. It is characterized by an effusion of light yellow color, clear, normal viscosity, with a dense mucinous clot. At the same time, the content of protein, glucose and lactic acid in the sweat is normal, and the number of cells does not exceed 5000 in 1 mm3, mononuclear cells predominate over polymorphonuclear leukocytes.
Inflammation occurs periodically. It is characterized by mild swelling, fever, and soreness. All these symptoms persist for 3-4 days, in some cases are delayed by 10-15.In some patients, depending on the nature of the lesion and working conditions, inflammatory changes in the joint( secondary suppuration) can recur every 2-3 months. All this leads to the development of sclerotic changes in the synovium. This process negatively affects the functional state of synovial fluid and cartilage tissue. Over time, there are fibrotic changes in periarticular tissues. At the last stage of the process, individual fragments of coarse osteophytes can come off and remain in the free state in the joint cavity. When you fall into the articular gap, the formation causes severe pain, and the patient is deprived of the opportunity to move.
Positive pain in affected diarrhea relapses secondary suppuration. For this, the state is characterized by the displacement of the limb axis, the restriction of active and passive movement in the joints. This leads to the hypotrophy of the regional muscles, which along with the thickening of the periarticular tissues, the displacement of the patella promotes the deformation of the joint. The most pronounced violations of these parameters of muscle function are characteristic for relapse, at a later stage of the disease.
Purulent synovitis often occurs after wounds, bruises and other damages of diarthrosis. It can develop during the process transition from paraarticular tissues, tendon sheaths, synovial burs associated with the joint. Metastatic suppurative inflammations are observed in sepsis, postpartum infection, washing, paratyphoid, omphalophlebitis, etc.
The diagnosis is based solely on clinical signs and anamnestic data. The correctness of its formulation in necessary cases is confirmed by puncture of the joint and examination of the punctate. At the initial stage of the lesion, when macroscopic changes in synovia are difficult to establish, a qualitative trial with trichloroacetic acid is used. To do this, pour 3-5 ml of a 5 or 10% solution of this acid into the tube and add 2-3 drops of puncture to it, which, under the action of acid, coagulates and disintegrates into small, rapidly settling to the bottom of a test tube of a clump. The upper part of the solution remains almost transparent in the test tube. The drops of synovia, which were removed from healthy diarthrosis, also coagulate when they are added to the solution, but the loose loose clot does not dissolve into clumps and does not settle to the bottom of the test tube.
Proliferative synovitis is the most common form of the disease. He is due to serious injuries. The shell begins to produce a large amount of effusion. It is cloudy, and contains a lot of protein. The pathological fluid, most often, accumulates in the region of the hip joint. Synovitis, as a rule, is accompanied by increased pressure in the joint cavity. All this indicates that it is necessary to begin treatment as early as possible in order to prevent the violation of motor function in humans.
There are only 4 degrees of proliferative spacing: a thickening of the synovia without significant villous proliferation, the appearance of focal villi accumulations on the background of thickened synovia, the villi cover most of the synovium of the lateral parts of the joint, leaving the upper section, diffuse villous proliferation, that covers all the departments of diarthrosis.
In inflammation of the secondary-type knee, patients with osteoarthritis observe an effusion of light yellow color, normal viscosity, transparent, with a dense mucinous clot.
Recurrent synovitis occurs with a poorly cured acute form of the disease. It is accompanied by chronic forms of dropsy. At the same time, due to constant pressure on the synovial membrane, its hypotrophy and fibrosis develops. All this leads to a violation of the outflow and absorption capacity. There is a vicious circle, aggravating the course of suppuration and development of degenerative-dystrophic changes in the joint occurs.
As the inflammation progresses, the size of the pathological focus increases. With active treatment, this leads to a change in the ratio between the amount of drug administered into the compound and the mass of the affected tissue. On the other hand, this significantly worsens circulation of the fluid in diarrhea and makes it more difficult for the drug to enter the inflammation zone. Eliminate this type of defeat is not so simple. Because if it has arisen once, then subsequent cases of re-inflammation are not ruled out.
Nodular synovitis is mainly expressed in a tumor-like intraarticular node with a diameter of 1-8 cm, varying in shape and color. Men suffer from inflammation twice as often as women. As for the node, it consists of a large number of fibroblasts. Myofibroblasts, primitive mesenchymal cells and histiocytes "some of which contain hemosilerin or have a foamy cytoplasm.
The number of lymphocytes can range from insignificant to huge. Giant multi-nuclear cells can be found. In addition, there are fields collagenized »in places hyalineized fibrous tissue, in which foci of necrosis sometimes occur.
Localized nodular synovitis should be distinguished from synovial sarcoma. In the synovium, rare diseases such as synovial chondromatosis, synovial chondrosarcoma and intraarticular synovial sarcoma can also develop.
Vineous synovitis is classified as a number of slowly progressing diseases. The nasal and nodal growths gradually appear in the region of the synovial membranes of the joints and tendon shells at a young age. In general, large diarthrosis is affected, especially the knee. In addition to synovial membranes, the process can spread to neighboring tissues, including the adjacent bone.
According to histological data, PVNS can manifest itself in two types of cells: polyhedral mononuclears and giant multinucleated cells. Intracellular and extracellular deposits of hemosiderin and lipids are found in the lesion focus.
In some cases, there are fields of lymphocytic infiltration. Monocular cells have the form of histiocytes. To date, there is no specific data on the origin of the disease.
Hypertrophic synovitis is a chronic disease. This diagnosis is made according to the morphological study of the synovial membrane. As a result of prolonged irritation of the synovium, pronounced growth( hypertrophy) of its villi is noted. This leads to numerous unpleasant symptoms.
With pronounced hypertrophic inflammation, when the synovia thickness reaches 1 cm or more, the application of this method to chemical synovectomy significantly facilitates the tolerance of the course, and the use as preoperative preparation greatly facilitates the performance of the surgical procedure shown in some cases. The treatment was carried out according to the following protocol: the drug was injected into the cavity of diarrtosis twice a week in the amount of 5 ml of glucose solution into small joints( ulnar, humerus, ankle) and 10 ml into the knee joint. It is important to start treatment on time, or rather to maintain affected diarrhea. Basting in this form gives the person a lot of inconvenience.
Synovitis in a child
Synovitis in a child is very rarely characterized by severe pain in the hip joint during movement, which causes parents to understand the anxiety and anxiety. True, this malaise goes by itself, usually within a week, without any serious consequences. Preliminary it is necessary to exclude other possible causes of pain in the joint. In many cases, the exact cause of transient inflammation of the hip joint remains unknown. Presumably, the disorder is the result of activation of the immune system due to infection. There is an opinion that this is not a true articular infection, but joint inflammation. The cause of which is the infection of the upper respiratory tract. At a time when the immune system responds to infection. Whether it's the flu or inflammation of the airways, the child has pain caused by a temporary inflammation of the diarrhea. This is a typical reaction of the immune system to viral infections. It is not possible to prevent it even with the help of vaccination.
True transient synovitis, as a rule, does not lead to any serious complications. Basically, this is a short-term state,. It usually lasts no more than a week. Ultrasound or magnetic resonance imaging can reveal excess fluid in the hip joint, the so-called effusion. It is extremely important to confirm the diagnosis as soon as possible by examination. With inflammation of lameness, pain and discomfort usually pass about a week later. Most of them last from three to four days, but the duration of symptoms up to seven days should not worry a person. If the symptoms persist for longer than a week, an additional examination is necessary.
Diagnosis of synovitis
Diagnosis of synovitis involves a certain algorithm.
First inspection is carried out. The specialist reveals a change in the size of the joint, its deformation, redness of the skin, fever, soreness in palpation and movement, as well as the limitation of the motility of diarthrosis and other changes.
Laboratory investigations are then carried out. With intensively developing infectious processes, it is possible to detect inflammatory changes, in general, and biochemical blood tests. With allergic manifestations, it is easy to detect an increase in eosinophils in the blood, immunological shifts( an increase in immunoglobulins of class E).If the process has developed against the background of rheumatoid arthritis, then the relevant biochemical markers are determined.
X-ray method is included in a number of diagnostic measures to identify the disease. Computer and magnetic resonance imaging, ultrasound, reveal the expansion of the joint cavity, in some cases it can be found.
The connection point is the last step in the diagnosis. Moreover, this is the main diagnostic method for detecting inflammation. Depending on the fluid obtained, it is possible to determine the nature of the exudate, identify an infectious agent and determine its sensitivity to antibacterial drugs. In many cases, puncture is also used for therapeutic purposes. With puncture, you can simultaneously perform arthroscopy. As additional research methods use arthrography, arthropneumography, biopsy.
Synovitis echoes are completely dependent on the site of inflammation localization. So, first of all diarrhea itself suffers. There, inflammation and damage to healthy tissue can occur. Moreover, the formation of effusion is not excluded. It usually contains a lot of protein.
In general, it is difficult to say unambiguously about echoes. After all, as mentioned above, they completely depend on the site of inflammation localization and its predecessor. Because the damage can develop against the background of the existing disease and become a sign of complication. In other cases, the problem arises from serious injury, especially among athletes.
Only the doctor in charge can diagnose and review any changes. Based on the data obtained, all "deformations" are noted and a correct diagnosis is made.
Treatment of synovitis
Synovitis in patients should be treated at a complex level. First, the disturbed anatomical relationships are eliminated and then the metabolic shifts in the joint are corrected. As for the question of conservative or operative treatment, in each individual case it is necessary to decide individually depending on the severity of the lesion, the nature of the secondary intraarticular changes and other causes. If the indications for the operation have been confirmed, then it is necessary to proceed to the consideration of the first stage of elimination of inflammation. Naturally, a full course of drug correction of metabolic disorders of the internal environment of the joint, as well as effective restorative treatment.
Primary indications include early joint puncture with the evacuation of synovia and immobilization of the joint with a pressure bandage or patella. In some cases, stiffer stabilization of the joint with tires for rest for 5-7 days is required with the use of days of hypothermia( cold) for the first time. As for prolonged immobilization, it is undesirable without indications, since complications can arise.
Synovitis prophylaxis is the timely treatment of inflammatory diseases that can cause it.
It is necessary to be careful during sports training, to avoid falls and traumatization, to eat rationally to strengthen the ligament apparatus.
If you get any herbs, you should immediately go to the hospital. The fact is that inflammation in neglected form easily leads to the development of this disease. This must be understood.
In most cases, everything depends on the people themselves. If a person does not monitor his health and does not eliminate the consequences of injuries, then the disease can easily overtake. Moreover, not all people pay attention to the first signs of the disease. This only aggravates the situation and leads to a chronic form. Therefore, with the slightest injury, you must immediately contact a medical center.
Synovitis prognosis is entirely dependent on the variety of the disease. In acute forms, in case of correct and timely treatment, the symptoms of the disease are completely reversible.
If the synovitis has a recurrent or chronic character, with the prolonged existence of hydrarthrosis, the ligaments of the joint are stretched, it becomes loose. All these changes can lead to subluxation or even dislocation. Due to the destruction of the integumentary cartilage, it is possible to develop deforming arthrosis, contracture of the joint.
Severe infectious forms threaten human life. They require urgent medical treatment and treatment. As a result of purulent parasynovitis and panarthritis, later the wrinkling and scarring of surrounding tissues, which disrupt the function of the joint, develops. It is not excluded and relapses of the process and contractures of diarrtosis are possible even after surgical intervention. In general, in most cases the outlook is favorable. But in order for this to happen, it is necessary to begin treatment on time.
Synovitis of the shoulder joint: treatment |Are joints aching?
This disease is an inflammatory process of the joints shells and accumulation in the joint fluid bag. Basically, the synovitis of the shoulder joint can develop because of the resulting injury, arthritis or infection. Most often found in the elderly or middle-aged people, athletes.
Occurs during physical exertion, with injuries and bruises, resulting in increased fluid release. It accumulates in the joint and increases it. Also, it can appear without injury, simply because of the defeat of the synovial membrane by the detached meniscus, which is damaged by the cartilage. Acute traumatic synovitis develops rapidly and is the brightest in the severity of symptoms. It is characterized by increased body temperature, inflammation, malaise, severe pain and, as a consequence, restriction of mobility.
It is characterized by stagnation of blood and lymph in the area of the inflammation focus, pain and limited movement.
It is manifested by dropsy. Among aseptic synovitis, neurogenic and traumatic ones predominate. Infectious synovitis is caused by staphylococci, streptococci, causing inflammatory processes and forming foci of inflammation within the body.
When a diagnosis is made, internal injuries must be rectified. This is done both conservatively and surgically. To start the patient is examined to find out the causes of the disease. Treatment is selected depending on the stage of the development of the disease, the nature of its course. First, conservative intervention is used. This symptomatic therapy together with restorative, medicamental, physiotherapeutic and fortifying courses. My patients use a proven means, which can get rid of the pain in 2 weeks without much effort. Complex treatment of synovitis of the shoulder joint is aimed at eliminating disturbed anatomical relationships, correction of metabolism.
- puncture( i.e. sucking of synovial fluid with a special thin needle)
- fixative dressings, gypsum,
- tires, counterparty, heparin electrophoresis, phonophoresis and magnetotherapy.
In the acute phase of the disease, ultrasound with dimexin, hydrocortisone ointment, as well as with preparations that contain cholesterol compounds( liquid crystal) should be performed. Massage courses, gymnastics and physiotherapy exercises are prescribed. All procedures are carried out carefully, without rough pressing, within the limits of painlessness. If these methods prove to be ineffective, Novocain blockades are used. In most cases, a single procedure will suffice.
If conservative methods do not give positive results over a long period, an operation is prescribed. After surgery, a course of rehabilitation and drug therapy is conducted.
Untreated synovitis can recur, and lead to degenerative and dystrophic processes in the joint.
Treatment of synovitis of the shoulder joint, symptoms and causes of
Synovitis is an inflammation of the synovial membrane of the joint, resulting in an excess of synovial fluid in the joint cavity. Normally, the healthy synovial membrane surrounding the joint secrete synovial fluid in very small amounts( but sufficient to provide natural "lubrication" of the joints).Inflamed, the membrane begins to produce an excessive amount of "lubrication", which provokes discomfort and pain and leads to "swelling" of the joint. The synovitis of the shoulder joint most often develops as a result of injuries, but it can also have an infectious nature or arise against the background of arthritis.
Symptoms of acute and chronic synovitis
When infectious or traumatic synovitis, the disease progresses rapidly - for 1-2 days, with non-infectious - in 1-2 weeks. Main features:
- Painful swelling in the area between deltoid muscle and clavicle.
- Strongly expressed discomfort when trying to move the shoulder, the stiffness of the shoulder joint. Pain can irradiate( give) to the neck or arm from the side of the affected shoulder. Often the pain occurs when changing clothes, a patient with a hand is difficult to lift and carry objects regardless of their weight.
- To reduce the intensity of pain, the synovitis sufferer often holds his arm like a sling, that is, bending it at the elbow and pressing it to his chest.
- There is weakness, general malaise, often the temperature rises - either the whole body, or exclusively in the affected area. The difference is not difficult to see by putting the back of the palm first to the skin on the affected area of the shoulder, then to the skin on the adjacent healthy areas.
- With purulent synovitis, pronounced edema and severe redness of the shoulder skin are observed, the temperature rises sharply to 38 ° C and above, chills are observed, vomiting is possible.
Chronic synovitis develops as a consequence of an untreated acute synovitis. Symptoms - persistent( although tolerable) aching pain, increasing at night, malaise. It is possible to develop a dropsy of the joint, because the constantly evolving synovial fluid accumulates, not having time to suck in the membrane.
Inflammatory processes occurring in the synovial membrane, are divided into infectious and aseptic( that is, non-infectious).Possible causes of synovitis:
- bruises, dislocations, fractures, sports injuries, which lead to significant damage to the joint;
- monotonous and regularly repeating movements of the shoulders - for example, swimmers, basketball players, volleyball players;
- untrained weak ligaments;
- open wounds on the shoulder, deep cuts or scratches through which the infection penetrates;
- endocrine disorders( diabetes), neuritis, damage or pinched nerves in scoliosis or some neoplasms;
- arthritis, secondary osteoarthritis;
- infectious synovitis often develops as a complication after having suffered angina, bronchitis, pneumonia, or in patients with tuberculosis or syphilis when the infection enters the synovial membrane through lymph or blood;
- an allergic variety of synovitis develops with increased sensitivity of the cells of the joint capsule to certain endogenous chemicals.
Important! Among the terrible complications of synovitis - periarthritis( inflammation of the periarticular tissues) and panartrite, in which inflammation spreads to the bones, cartilages and ligaments. A sad result of the development of the inflammatory process can be a general sepsis. Among the complications of chronic non-infectious synovitis is dropsy, which causes joint loosening, which in turn can lead to chronic subluxation or dislocation of the shoulder.
The synovial joint cyst
is visible in the picture. Treatment and prevention of
Synovitis is diagnosed by an orthopedic traumatologist during external examination. In addition, an examination is performed to identify other disorders in the operation of the shoulder joint, which may complicate the treatment( lordosis, kyphosis, scoliosis).Assign tests - total blood, urine, as well as the study of synovial fluid to identify the causative agent of infection. In doubtful cases, to differentiate synovitis from arthritis or bursitis, an MRI or radiography is prescribed.
- Restriction of joint motor activity( immobilization).Used pressing bandages, tires, longs. In mild cases, when there is a high probability that the body will cope with inflammation on its own, the treatment consists in tight bandaging of the joint.
- In more difficult cases, a puncture is indicated: the joint is pierced with a thin needle, the synovial fluid is sucked off, then anti-inflammatory drugs or antibiotics are injected into the joint. Antibiotics are used if the inflammation is of an infectious nature. Penicillin, lincomycin, levomycetin are used, which are diluted in a solution of novocaine or other analgesics. If the inflammation is caused not by infection, mixtures of anti-inflammatory drugs( for example, betamezon and aprotinin), also diluted in a solution of novocaine, are used. After puncture appoint UHF or electrophoresis, if necessary, prescribe analgesics and ointments( for example, "Voltaren") and vitamin complexes.
- A triggered synovitis, persistently resistant to antibiotic or anti-inflammatory drugs, is treated surgically - complete or partial resection( removal) of the synovial membrane is performed.
Important! In the overwhelming majority of cases, the diagnosed synovitis in time is very succesful to conservative treatment. The recovery takes 1-2 weeks, as much as full rehabilitation. After elimination of the most acute symptoms, physiotherapy is prescribed, spa treatment with mud and hydrogen sulphide baths is recommended.
For the prevention of synovitis, urgent consultation is required in the event of inflammation and the presence of infectious diseases. While doing sports, excessive loads should be avoided and not only muscles but also ligaments should be trained.
Synovitis of the shoulder joint is an inflammation of the joint bag, which is characterized by changes in the composition of the synovial fluid followed by accumulation of effusion. As a rule, inflammation occurs in one joint. The defeat of several joints is quite rare.
It should be noted that synovitis may act as a secondary sign of another disease. For example, often a synovitis of the shoulder joint is present with secondary brachial osteoarthritis or arthritis. In this case, the treatment of the disease will be carried out in a complex manner, thus eliminating the cause of the inflammation of the synovial bag.
Causes of the disease
The most common cause of the disease is chronic or acute shoulder injury. It can be as fractures, and usual bruises and dislocations. Because of the injury, the synovial capsule produces an excessive amount of synovial fluid, which accumulates, inflames the joint capsule.
The synovitis of the shoulder joint, resulting from chronic trauma, is most often observed in athletes and people who in the course of physical work constantly perform monotonous movements of hands. The risk group includes people from the following professions: plasterers, painters, throwers, etc. Chronic synovitis usually occurs without obvious damage to the joint. His treatment often implies the elimination of the consequences of the injury.
Significantly less common is the infectious form of synovitis, the treatment of which involves fighting infection that has fallen into the joint, both from the periarticular tissues, and from individual foci.
Symptoms of synovitis
In acute aseptic synovitis of the shoulder joint, the patient complains of discomfort and moderate pain in the shoulder area. The affected joint and periarticular tissues are enlarged in volume and have a small edema. In some situations, little local hyperthermia can be observed, while the movement is slightly limited.
Puncture of the shoulder joint
Performing palpation of the joint, the patient may experience soreness. It should also be noted that with chronic synovitis, swelling and pain in the shoulder area is less pronounced.
Acute purulent form of synovitis develops rapidly rapidly and is accompanied by strong painful sensations even with the slightest movements of the shoulder. The skin in the shoulder region is hyperemic and the palpation is painful. For the purulent form of synovitis is characterized by fever, chills, weakness of the headache, etc.
Diagnosis and treatment
The most informative diagnosis, which can determine the cause and form of the sino-phyto, is a puncture, followed by investigation of synovial fluid, as well as ultrasound and CT of the shoulder joint. If necessary, the treating physician can be used arthroscopy. In case of suspicion of possible metabolic and endocrine disorders or allergic reaction, the patient is given advice of an endocrinologist, an allergist and other specialists.
In most cases, a favorable prognosis is achieved through conservative treatment. The patient is given peace and, if necessary, immobilizes the shoulder joint with a bandage bandage. When a large amount of synovial fluid accumulates, joint puncture is performed.
In the aseptic form of the disease, non-steroidal anti-inflammatory drugs are prescribed to the patient; if the synovitis is infectious, antibiotics are used. Chronic form of synovitis is characterized by a correction of metabolic disorders with the use of stabilizers of lysosome membranes and inhibitors.
Depending on the course of the disease, the patient is directed to phonophoresis, UHF, electrophoresis and various physiotherapy procedures. If during a long period of medication and the above procedures do not lead to a positive result, surgical intervention is performed. Depending on the severity of the disease, a partial, subtotal or total synovectomy of the shoulder joint is performed.
Below you can see the video of the blockade of the shoulder joint with synovitis.