Sitovitis is a disease in which an inflammation of the synovial joint of the joint occurs, it surrounds the joint itself. This is the name of the articular bag obtained because of the transparent synovial fluid filling it. Inflammation of this area occurs often as a result of infectious or viral diseases.
In addition, synovitis can be caused by trauma, stress and even allergies. This disease has sufficiently pronounced symptoms, so not to notice it is not possible, of course, the nature of the symptomatology depends on the individual characteristics of the patient, as well as on the stage of the disease.
Depending on the cause of the occurrence, two types of synovitis share:
- is infectious.
Traumatic synovitis is considered to be extremely common, because it can form as a result of even minor bruises. In addition to injury, the cause of this type of synovitis can be damage to the cartilage of the joint, as well as irritation of the synovial bag. Since children and elderly people are the most affected by traumatism, it is they who have this disease most often.
Clinical features of the disease
How to recognize the synovitis
In addition to the fact that synovitis is classified because of the onset, it can still differ in the site of the lesion. One of the most common today is the synovitis of the hip joint. This type of disease is accompanied by a decrease or lack of mobility of the affected joint, as a result of which the patient can not move normally.
Moreover, in the complex stages of the disease, there may be a lack of leg mobility. The second sign of synovitis is muscle spasm, which occurs in a region close to the outbreak of the disease.
Muscle spasm - as one of the main signs of synovitis
The patient can feel involuntary contraction and twitching of the muscles. There were cases when synovitis was accompanied by an increase in body temperature, but this symptom is extremely rare. At the stage of the development of the disease, there are painful sensations in the area of the affected joint, and at night they can become worse. Well, the last sign of synovitis can be considered visible changes, such as swelling, redness and even swelling.
It is also important to note that this disease can be acute and chronic. In acute synovitis, severe pain develops, which is significantly enhanced when the joint moves or when exposed to external influences. As for chronic synovitis, this is a consequence of ignoring the problem if the patient has not performed the correct treatment on time. A chronic synovitis is accompanied by a constant swelling of the affected joint.
How to diagnose the hip synovitis
In order to make the correct treatment and quickly get rid of synovitis, you need to see a doctor before the disease begins to progress. To determine the exact diagnosis, you need to undergo a test and perform several procedures.
The first method of diagnosing synovitis is an exercise called a frog, it is that a person taking a frog's position should withdraw his leg to the side, with a hip synovitis it is almost impossible to do this.
Diagnosis of the disease
In addition to this exercise, you need to determine the presence of lameness in the patient, it is enough just to go through several steps. It is over, on the basis of an external examination, it is difficult to determine the nature of the disease and its stage, so patients are often prescribed to take tests, check the heartbeat and body temperature. An x-ray image of the patient's joint is also mandatory for the diagnosis of synovitis.
Treatment of hip synovitis
First of all, it should be noted that the treatment of synovitis should be complex and individual, so it is very important that it is prescribed by a doctor in accordance with the characteristics of the patient and the form of the disease. The correct treatment prescribed by a specialist is the main condition for a quick recovery.
The first stage of the treatment is to determine the cause of the disease and if the synovitis in the patient is caused by an infection, then the cause of the disease must be eliminated first.
Hip replacement as an effective treatment for
The next step in the treatment of this ailment is taking medications to relieve inflammation, reduce pain, and if necessary, febrifuge. It's over for the strengthening of immunity and more rapid recovery of the patient should take vitamins.
It is highly recommended to intensify the effect of the main treatment when physiotherapeutic procedures are prescribed for synovitis, they will help strengthen the effect of taking medications and, accordingly, accelerate recovery.
In the case of severe stages of the disease, surgical intervention may be required, after which the patient must undergo a rehabilitation course. Any treatment of synovitis should begin with a complete resting of the patient and immobilization of the affected joint. If you fulfill these conditions then the effect of treatment can be noticed quite quickly. To immobilize the joint, you can use special devices, such as gypsum, tire, squeezing bandages or clamps.
It is very important to understand that synovitis is a disease that can have serious consequences, it should be taken into account in the course of treatment, especially for severe forms of the disease.
In severe form of this disease, which is also called a purulent infection, blood infection can occur, accordingly, when treating the disease itself, it is necessary to take into account such consequences. The mild stage of synovitis is often treated in just a couple of weeks, but whatever it is, the treatment should be under the supervision of a doctor.
LFK with hip joint disease
With regard to preventive measures, they can include regular exercise and proper nutrition. In order to avoid the emergence of a complex form of synovitis, it is necessary to contact specialists in a timely manner. Purulent synovitis can be very dangerous, because the incorrect treatment of this form of the disease can lead to disability.
Folk methods of treatment of hip synovitis
Folk medicine is very effective in many existing human diseases, but it is worth remembering that it is most often used as ancillary techniques. It is due to the fact that it is quite difficult to achieve full recovery with the help of folk remedies. But with all this, traditional medicine can allow to greatly enhance the effect of basic treatment.
For the treatment of synovitis, ointments, compresses and tinctures prepared from natural herbs will be very effective. Especially useful in this disease are such herbs as oregano, thyme, comfrey, St. John's wort and rye.
Compresses and ointments - folk remedies
It is quite easy to prepare a medicine from the above mentioned herbs, for example, by taking one tablespoon of thyme, tansy, birch leaves, eucalyptus and yarrow, you can prepare a decoction. For compresses, you can use comfrey filled with boiling water and stayed overnight.
Despite the fact that folk methods in principle are not dangerous and do not harm human health, they need to be applied only by coordinating the application in advance with the attending physician. Moreover, especially to the use of folk recipes should be treated with allergies, since some herbs can cause allergic reactions.
Summing up, we can say that synovitis is a serious disease that is accompanied by vivid symptomatology and significantly affects the quality of life of a person. But, despite this, in the early stages of the disease is easy enough to treat, which can not be said about the neglected synovitis. In the process of development, the disease can acquire a purulent form, the treatment of which requires surgical intervention, and in rare cases can lead to disability.
Video - Hip joint synovitis
Inflammation of the synovial membrane of the hip joint with the formation of an effusion into its cavity is called synovitis. The disease occurs in adults and ranks third after inflammation of the knee and elbow joint.
The pathological process can develop in childhood, while it has an acute progressive course and can cause lameness formation. The synovitis of the hip joint is more often one-sided, with timely treatment has a favorable outcome with complete restoration of the motor function in the lower limbs.
Classification of the disease
The inflammatory process in the hip joint is divided into species depending on the cause of the disease.
- Infectious synovitis is a pathological process that develops when bacteria and viruses enter the blood and lymph flow through the wound surface of the skin.
- Reactive synovitis - inside the hip articulation, aseptic( without the direct influence of the pathogenic flora), inflammation arises as a result of the immune reaction of the body to the infectious process in internal organs with the formation of antibodies to its own tissues.
- Traumatic synovitis - develops as a result of injury or injury to the hip joint, while the normal functioning of the synovial membrane that excessively secretes the intra-articular fluid is impaired.
- Chronic synovitis - occurs when there is insufficient therapy for an acute inflammatory process or when there is no treatment.
- Transit synovitis - occurs after a bacterial or viral infection, increased physical stress on the hip joint, is typical for children aged 3-14 years.
To prevent the formation of a chronic form of the disease at the first signs of the pathological process, it is necessary to consult a doctor.
Disease Hip synovitis may be aseptic and infectious. With aseptic inflammation, the synovial fluid is sterile, does not contain a pathogenic microflora. Its development is promoted by the following factors:
- disruption of the synovial sheath integrity as a result of traumatization of the hip joint( dislocation, subluxation, fracture, bruise);
- autoimmune pathology, systemic diseases( rheumatoid arthritis, vasculitis);
- allergic reactions;
- diseases of a neurogenic nature( neuritis, neurosis, chronic stress);
- metabolic disorders and metabolic disorders;
- of the endocrine system( gout, diabetes mellitus).
Anatomical structures involved in the formation of the hip joint
Infectious synovitis is divided into nonspecific and specific. Nonspecific inflammatory process is associated with the penetration of pathogenic viruses( influenza, herpes) and bacteria( staphylococci, streptococci, Klebsiella) into the interior. Specific arthritis develops due to damage to the body such diseases as syphilis, tuberculosis, diphtheria, anthrax. Revealing the cause of the disease is important for the appointment of a comprehensive targeted treatment of pathology.
Clinical picture of
In the vast majority of cases, the synovitis of the hip joint begins gradually with the appearance of a minor soreness and an increase in the joint due to the accumulation of an inflammatory exudate. As the pathology progresses, the intensity of the symptoms increases and disrupts the full motor activity in the lower limb.
Clinical signs of the disease include:
- pain in the hip joint at rest, with little physical activity, climbing stairs, walking;
- discomfort at night, which indicates the progression of the disease;
- violation of movements in the affected joint until complete cessation( blockade);
- spontaneous contraction of the muscle fibers of the hip, increasing muscle tone in the area of the affected joint;
- local manifestation of the inflammatory process in the form of swelling, redness of the skin, increased temperature in the pathological process;
- general malaise, subfebrile condition( body temperature - 37-37.9 degrees).
Hip synovitis in children differs from the disease in older age. Pathology develops against a background of a bacterial or viral infection( sore throats, pharyngitis, tonsillitis, otitis), often the cause of the disease is intense physical activity. Arthritis in the child appears lightning, there are intense pain in the hip joint with irradiation in the thigh and knee, especially in the mornings. This causes the patient to keep his foot on the side of the lesion in a bent state and brought to the opposite lower limb. During walking, noticeable lameness, which can go to a chronic form with untimely begun therapy. Symptoms disappear without a trace after the anti-inflammatory treatment.
Diagnosis and treatment tactic
Therapy of the disease is appointed after finding out the cause of the pathological process. The main method of diagnosis is puncture of the joint for the extraction of synovial fluid and the study of its composition. With infectious arthritis, exudate contains pathogenic microorganisms, leukocytes, an admixture of pus. Aseptic inflammation may be accompanied by an increase in the viscosity of the synovial fluid due to the high protein content, sometimes traces of blood are found. In addition, x-rays and joint ultrasonography, arthroscopy, cytological examination and synovial membrane biopsy are prescribed.
Healthy hip joint on the right and altered by a dystrophic inflammation process on the left
Treatment of synovitis of the hip joint includes:You can also read: Diagnosis of hip dysplasia
- non-steroidal anti-inflammatory drugs( nimesulide, diclofenac, movalis) - actively affect the inflammation, reduce the feverbody, eliminate pain syndrome;
- hormonal agents( prednisone, dexamethasone) - are prescribed in severe clinical cases in tableted and injectable forms, for the introduction inside the joint;
- antibiotics( ceftriaxone, erythromycin, cefazolin) - used for infectious arthritis, injected into the joint during the extraction or pumping of synovial fluid;
- inhibitors of proteolytic enzymes( contrikal, trasilol) - recommended for insertion into the cavity of the hip joint, prevent the development of complications;
- trophic drugs( nicotinic acid, tiatriazolin) - improve microcirculation, normalize metabolic processes in pathology;
- multivitamins( vitrum, decamit) - strengthen the defenses of the body.
In the case of a severe course of the disease with joint suppuration, surgical intervention is prescribed - synovectomy. In this case, pus, blood clots, necrotic tissue are removed from the hip joint, antibiotics are introduced to kill the pathogenic microflora. In the recovery period, physiotherapy( electrophoresis, UHF) and a set of curative gymnastics are used to restore the functional activity of the limb.
Inflammation of the synovial membrane of the hip joint should be diagnosed at an early stage of the disease. Timely treatment restores the anatomical structures of the affected joint and its function in full. The development of the chronic process worsens the prognosis of the disease and leads to the development of lameness, the destruction of cartilage and ligamentous apparatus, the constant accumulation of exudate inside the synovial bag.
How to treat synovial inflammation of the hip joint
In the hip joint, there are often extensive inflammatory processes - coxites, affecting the tissues of ligaments, tendons, bags and synovial membranes. Such inflammation is usually characteristic of arthritis of the hip joint. A type of coxite - synovitis of the hip joint in adults is a phenomenon more rare than the synovitis of the knee joint.
TBS in an adult is more likely to suffer from degenerative( arthrosis) changes, but in children - coxitis, in particular, inflammation of the synovium of TBS, or as it is also called, transient synovitis.
Causes and types of hip synovitis
Causes of synovitis of the hip are mostly traumatic or infectious:
- Fractures, dislocations, bruises of the TBS.
- Bacterial and viral infections( streptococcal, staphylococcal, measles, chickenpox, influenza, parovirus, etc.).
- Specific infections( tuberculosis, gonorrhea, syphilis, brucellosis).
- Some intestinal and urogenital infections( salmonellosis, chlamydia, mycoplasmosis, helminthic invasions).
Aseptic synovitis of TBS
However, aseptic forms are also known when synovitis develops due to systemic joint diseases such as rheumatoid arthritis and Bekhterev's disease.
Lead to aseptic synovitis of TBS can also:
- allergic arthritis;
- endocrine abnormalities of the thyroid, pancreas;
- autoimmune diseases and metabolic disorders;
- peripheral nerve damage;
- congenital joint anomalies( eg, congenital dislocation of TBS);
- toxic and chemical effects.
Primary and secondary synovitis
Hip synovitis may be primary and secondary( osteo-primary):
- primary is associated with rheumatoid or infectious arthritis;
- secondary-with processes occurring in the bones( tuberculosis, osteomyelitis, purulent-necrotic post-traumatic processes).
Symptoms of hip synovitis
Synovitis of TBS can manifest itself late enough, except for infectious-allergenic arthritis in children:
- In this case, the disease develops violently, with a high temperature.
- The painful joint swells quickly, the movements become limited and cause pain to the child, as well as the palpation of the TBS region.
In adults, usually pain symptoms and discomfort during movement increase gradually.
- Skin over the area of pathology can blush, and the joint from the affected side looks great because of the swelling.
- If the synovial bag is damaged, puffiness builds up very quickly.
- Sharp painful lumbago can be replaced by a throbbing pain.
- Muscles in the TBS region are strained and spasmodic.
- In chronic synovitis, characteristic symptoms appear:
- permanent hydroarthrosis( dropsy) of the joint;
- muscular atrophy;
- the limb on the sore side looks less developed.
Synovitis of transient hip joint in children
The reason why in children aged one and a half to 15 years( most often affected by children in the range of three to seven years) is still unknown:
- , about a third of the children who had fallen ill transferred ARVI orflu;
- in others the synovitis has developed after an injury or load, for example, a long walk;
- in a small number of children, the causes of the pathology and remained unexplained.
Symptoms of transient synovitis of TBS in children
- The disease begins with acute pain symptoms, with a morning maximum.
- Body temperature and ESR are usually within normal limits.
- Flexion, extension, rotation of TBS occur with limited amplitude and are very painful.
- Appears limp.
- In a markedly forced position of the foot( the child takes the half-bent limb aside).
- The lesion of TBS is usually one-sided.
Most doctors are inclined to think that the transient synovitis of the hip joint in children is still viral, since in the blood of the sick there is an increase in the immunity factor - interferon.
However, the same signs can also occur in autoimmune pathologies. Also to doubt the infectious nature is caused by the sterile composition of the synovial fluid, taken with exacerbation of synovitis in children.
When examining children's arthritis and its transient synovial manifestations, it is necessary to differentiate them from rheumatoid or infectious arthritis. Suspicion that this is another disease, can cause the following symptoms:
- febrile( above 37.5 ° C) temperature;
- ESR ≥ 20mm / h;
- increased rheumatoid.
If neither transient synovitis, nor rheumatic, or infectious arthritis is confirmed, it is necessary to take a closer look at the aseptic types of arthritis listed above. This form of arthritis, like allergic, in children is quite common.
The same diseases that can be attributed to autoimmune, metabolic or allergenic( for example, psoriasis or gout) practically have no early articular manifestations.
Integrated Diagnosis of Synovitis TBS
- After external examination of the joint, a primary instrumental diagnosis is carried out, usually using an X-ray. The accumulation of exudate will look like a blackout in the image.
- For further details, an additional examination may be required:
- ultrasound, arthroscopy, arthropneumography, MT or CT.
- A synovial fluid puncture is performed:
- with an aseptic synovitis is sterile;
- with septic synovitis fluid contains blood clots, pus, protein, pathogens - in this case, the cavity should be freed from the synovial fluid, carrying out its evacuation, and then rinse the TBS cavity with an antibiotic.
- The cytology of exudate allows to reveal its biocompatibility, source of infection and to select appropriate drug therapy.
How to treat synovitis of the hip joint
Treatment of synovitis of the hip joint goes in two main directions:
- Withdrawal of painful inflammatory symptoms.
- Elimination of the direct source of synovitis, if known:
- effects of trauma;
- bacterial infection;
- disturbed metabolism;
- chronic diseases;
- allergies, etc.
In an acute period of synovitis, TBS should be immobilized, limiting the load on it.
What medications are used for synovitis of TBE
- Treatment of pain with synovitis of TBS is performed by non-steroidal anti-inflammatory drugs( ASV14):
- with ibuprofen, diclofenac, nimesulide.
- Acute reactive synovitis is well served by treatment with dexamethosone, hydrocortisone and other corticosteroids.
- At an early stage, if synovitis is accompanied by hemarthrosis, inhibitors of proteolytic enzymes are introduced along with puncture into the joint cavity, slowing down fibrinolysis( dissolution of blood clots and thrombi):
- tracerol, gudox
- In chronic purulent synovitis, TBS, on the contrary, requires enzymes that have antibacterial andsplitting properties:
- lysozin, trypsin.
- To improve circulation, restore cell membranes in joint tissues, use:
- nicotinic acid, heparin, and other agents.
Surgical treatment of synovitis
It is mainly used in the aggressive form of synovitis, when conservative therapy does not help, as well as with traumatic synovitis.
Surgery on the synovial membrane is called a synovectomy.
With this intervention, the surgeon performs the following actions:
- opens the joint bag;
- removes pus, blood, foreign bodies from the cavity;
- excision of the most affected area of the synovium.
After operation, TBS is fixed with a tire.
Restoration of the hip joint is performed:
- complex physical therapy;
- physiotherapy( UHF, electrophoresis, mud therapy, paraffin treatment, etc.)
- vitamin-mineral complexes;
- therapeutic diet;
- with traditional medicine.
Prevention of synovitis of TBS
Prevention of synovitis is all measures related to the prevention of injuries and pathologies in the joints:
- It is necessary to diagnose and treat the trauma of TBS in time.
- Do not allow chronic inflammation in the joints.
- Promptly treat all infectious diseases that can lead to arthritis.
- When practicing sports and physical activities, try to distribute loads evenly, without injuring the musculoskeletal system.
Traditional treatment of synovitis of the hip joint
Folk remedies for the treatment of synovitis TBS are used as ancillary, mainly aimed at relieving pain or restoring mobility. They must be combined with traditional complex treatment. It is especially effective to apply them together with massage and exercise therapy.
Several folk recipes for the treatment of synovitis TBS
- Butter from bay leaves:
- Several crushed laurel leaves pour 200 g of vegetable oil and insist two weeks in a dark pantry or cupboard.
- Wipe the oil in a circular motion in the area of TBS.
- Broth from the color of elderberry( one part), willow bark( 4 parts) and birch leaves( 5 parts):
- Collect 0.5 liter of boiling water, insist one hour.
- Drink 3 - 4 times a day for half a glass for 30 minutes.before meals.
- Compresses from propolis:
- 10 g pour 100 g of good vodka and insist a week in the refrigerator.
- Piece of linen or cotton cloth moistened in solution and attach to the diseased area, top covered with cellophane and woolen shawl.
- Compress can be done overnight, or applied in the afternoon for several hours.
- Comfrey roots( tincture):
- Pour one part of the crushed roots with four parts of vodka.
- Insist in a dark place for two weeks.
- Apply 30 drops three times a day.
Prognosis for treatment of
Most synovitis species, if not started, are well treated.
If the cause of the disease is eliminated - infection, the consequences of trauma, dysplasia of TBS, then the synovitis passes.
It is more difficult to treat chronic synovitis in rheumatoid, allergic arthritis, Bechterew's disease, and also with idiomatic( hereditary or autoimmune) arthritis.
Video: Hip dysplasia.
Synovitis of the hip joint
Synovitis of the hip joint - inflammation of the synovium, accompanied by the accumulation of fluid in the joint cavity. The cause of development is usually an infection or traumatic lesion. Children may have synovitis caused by viral diseases( eg, influenza) or prolonged walking. Synovitis is manifested by pain, swelling, obstruction, and restriction of movement. With infectious synovitis, there is an increase in temperature and symptoms of general intoxication. To clarify the diagnosis, use radiography, ultrasound and joint puncture. Treatment is usually conservative.
Hip synovitis is an infectious or aseptic process in the synovial membrane of the joint. It is accompanied by the accumulation of fluid in the joint cavity. It is a polyetiological disease( can occur for various reasons), is more often detected in children and adolescents. The prognosis is favorable, in the overwhelming majority of cases it ends with a complete recovery. Rarely passes into a chronic form.
The cause of development is usually the injury of the joint( including sports).Among other reasons - allergic reactions, endocrine pathology, neurological disorders, arthritis, hemophilia, degenerative-dystrophic lesion( arthrosis of the hip joint).Sometimes synovitis is observed in sciatica( inflammation of the sciatic nerve).As the causative agent of infectious synovitis, pneumococci, staphylococci or streptococci usually occur, less often the inflammatory process develops against the background of a specific infection( syphilis or tuberculosis).
In view of the etiology in orthopedics and traumatology, the following synovitis types are distinguished:
- Traumatic - the most common, occurs as a result of mechanical injuries( bruises, sprains).
- Infectious - develops when pathogenic microorganisms penetrate the synovial membrane. Perhaps both contact, and lymphogenous or hematogenous spread of infection.
- Reactive - is the response of the body to any pathological process( intoxication, somatic disease).It is considered as a kind of allergic reaction.
- Transient - usually occurs in children and adolescents under 15 years of age, most often affected by boys. The cause is presumably a viral infection( eg, influenza) or an overload of the joint with prolonged walking.
In the absence of treatment or inadequate treatment, acute synovitis may transition to a chronic form, however, this happens infrequently. According to the nature of the effusion, acute aseptic( noninfectious) synovitis is usually serous, acute infectious - purulent. In chronic synovitis, mixed forms of exudate predominate: serous-hemorrhagic, serous-fibrinous, etc. The most unfavorable are fibrinous( adherent forms) accompanied by gradual sclerosis of the synovial membrane.
Symptoms of hip synovitis
Patient is concerned about pain in the hip joint. With aseptic synovitis, the pain syndrome is mild or moderate. The area of the lesion is edematic, a change in the shape of the joint may be revealed( more noticeably when the joints are examined comparatively).Perhaps some restriction of the support, while walking the patient tries to spare the affected limb, sometimes there is lameness. Movement is moderately or marginally limited. When palpation of the joint pain increases. When checking the "frog test"( trying to bend the bent legs to the sides, lying on the back), a limitation of the lead is detected.
When infectious synovitis, all symptoms are more pronounced. The pain is intense, the swelling of the joint is clearly visible, local hyperemia and hyperthermia are revealed. There is a pronounced restriction of movements, the patient spares his foot, walking is difficult. Local symptoms of synovitis are supplemented by symptoms of general intoxication: fever to 38-38.5 degrees, general weakness, lethargy, chills, chills, loss of appetite, headache, nausea, or vomiting.
Diagnosis of hip synovitis
Diagnosis is made based on the results of the examination and additional research data. To exclude skeletal pathology and identify a possible cause of synovitis, x-ray of the hip is prescribed. For detailed study of intra-articular structures, joint ultrasound is used. The most informative study that allows to determine the nature, and in some cases - the cause of the development of synovitis, is a hip puncture with subsequent investigation of the synovial fluid.
In a number of cases, synovitis has to be differentiated with abdominal damage, pathological manifestations of the genital organs and diseases of the lower spine. Usually for the elimination of extraarticular pathology, a thorough examination is sufficient. In difficult cases appoint consultations of other specialists: a neurologist, a therapist, a gastroenterologist, a surgeon, a urologist, etc. Sometimes a roentgenography of the spine is performed in the lower parts.
Treatment of synovitis of the hip joint
Treatment of synovitis is complex, while drawing up a treatment plan, an individual approach is applied taking into account the form and stage of the disease, as well as the severity of clinical symptoms. Patients are recommended rest, prescribe analgesics, vitamin complexes, immunostimulants and physiotherapy procedures. In infectious synovitis, antipyretic agents are used. In acute aseptic synovitis, non-steroidal anti-inflammatory drugs are used: voltaren, ibuprofen, movalis, indomethacin, brufen, etc.
With recurrent synovitis, blockages with glucocorticoids are performed. Therapy of chronic synovitis is carried out using medications that regulate the production of synovial fluid and stabilizers of cell membranes( trasilol, countercranial).Patients are referred for phonophoresis, electrophoresis, shock wave therapy, massage and exercise therapy. Indications for surgical treatment are irreversible changes in the internal membrane of the joint( sclerotic degeneration, the formation of hypertrophic villi and petrificata).Depending on the prevalence of pathological changes, a partial synovectomy is performed, removing only the affected areas, or completely excising the synovial membrane.
Hip synovitis: inflammation of the joint membrane - Sustavy-Bezboli.ru
Inflammation of the articular hip joint with congestion in the synovial bag, articular cavity and in the vagina of the tendon is called synovitis of the hip joint.
Hip synovitis is an inflammatory process that affects the synovial membrane and is accompanied by the formation of a pathological effusion( exudate).Fortunately, this is a fairly rare pathology( it is much more common in clinical practice to be found driving, or synovitis of the knee joint).
Inflammation of the synovial membrane of the hip joint, or synovitis, according to the nature of the resulting effusion, can be serous, serous-fibrinous, hemorrhagic and purulent. According to the clinical course, this pathology is acute and chronic.
With the development of inflammation in the shell of the articular bag, a pronounced vascular reaction is observed. When the disease passes to the chronic form, there is a significant thickening of the synovium due to its predisposition to fibrous degeneration.
Often with recurrent synovitis thickening of the fibrous capsule and dilatation of the joint( a consequence of a sharp extension of the cassulary-ligament apparatus) is observed.
- Pathologies of a neurogenic nature.
- Hormonal disorders.
- Penetration of an infectious agent causing inflammation( trauma, injury, as well as transmission of the infection by lymphogenous or hematogenous pathways from internal infectious foci).
- Arthritis, hemophilia.
When the acute form of the disease develops, patients complain of severe pain in the joint, the temperature rises, a significant amount of inflammatory exudate is formed in the synovial bag and effusion is observed. This pathology leads to a significant limitation of mobility.
Chronic hip synovitis is a very rare disease characterized by the presence of a blurred( erased) pain syndrome and periodic accumulation of exudate.
Patients complain of rapid fatigue and minor aching pains that occur when walking. When accumulating in the joint cavity effusion may develop a dropsy of the joint. This condition is accompanied by stretching of the ligaments, dislocation of the joint and complete immobilization of the patient. With a long course of the disease, degenerative-dystrophic processes occur in the joint, and coxarthrosis of the hip joint develops.
The patient is assigned an X-ray examination, and joint arthroscopy, ultrasound and articular puncture are indicated for determining the type of pathology.
Treatment and prevention of the disease
Treatment of the disease is prescribed only when the attending physician is convinced of the correct diagnosis. Conservative therapy involves the appointment of anti-inflammatory drugs of non-steroidal nature and antibacterial drugs. Immobilization of the hip joint is also shown.
If necessary, intraarticular puncture is prescribed followed by the removal of inflammatory exudate. Folk healers also have effective prescriptions for treating this pathology.
When the patient's condition does not improve seven days after active treatment, proteolytic enzyme inhibitors may be necessary.
To prevent the development of synovitis, specialists urge that all infectious pathologies be removed in a timely manner and, if pain arises in the joints, immediately consult a specialist.( 2 votes, average: 4.50 of 5) Loading. ..
Synovitis of the hip joint: stages of treatment
The inflammatory process that develops in the articular cavity( specifically the synovial membrane) and leads to congestionin it liquids are called the synovitis .The synovitis of the joint is most often observed in boys under the age of ten, one of its consequences may be lameness.
Causes and forms of synovitis
In medical science, it is customary to classify synovitis for causes of emergence, distinguishing between two groups: infectious and aseptic. Among the aseptic causes of the emergence and development of synovitis prevail traumatic, followed by allergic, then neurogenic and others. Infectious synovitis can provoke pathogenic microorganisms, such as staphylococci, pneumococci, tuberculous mycobacteria, streptococci and so on.
According to the forms of the disease, it is customary to isolate acute( lasts an average of 14 days) and chronic. The second is not so common and, as a rule, is caused by incorrect or delayed treatment of acute synovitis.
Symptoms of hip synovitis
One of the reasons why the treatment of synovitis begins unintentionally is the absence of sharp pain. This aching is characterized by aching pain, it manifests itself during movement, is easily tolerated, and at rest it is not felt at all, therefore, until a certain moment the patient prefers not to notice it just like muscle spasms. The first and main sign of the synovitis of the hip joint is a tangible increase in the joint in the volume of , which occurs due to fluid accumulation.
Diagnosis of synovitis
Treatment of synovitis always involves a complex of medical measures aimed at eliminating the causes of the disease and restoring the functions of the joint.
There are several reliable methods for diagnosing synovitis, but the main one is a puncture, during which the specialist uses a needle to draw fluid from the joint cavity, and then injects antibiotics into it for prevention purposes( regardless of whether we have infectious or aseptic synovitisa business).Then, the fluid obtained during the puncture is sent to the study, according to the results of which it will be determined whether further treatment will only be medicated( and how) or whether it will be necessary to conduct an operative intervention with further therapy with anti-inflammatory drugs.
Treatment of synovitis
After the puncture, the doctor fixes the joint using a tight bandage to maintain its immobility, thereby reducing the load. This procedure is called immobilization of .The bandage is recommended to use no more than a week.
At the same time, the patient begins reception of non-steroidal anti-inflammatory drugs .The most common means for the treatment of synovitis are ibuprofen, diclofenac, voltaren, indomethacin, movalis and others. The method of administration( oral or topical) and dosage is prescribed by the doctor, guided by the results of the study, individual contraindications and peculiarities of the course of the disease.
Hip synovitis is an inflammatory disease that affects the inner surface of the synovium.then leads to the accumulation of exudate in the cavity of the hip joint. Externally manifested by edema in the affected area. Painful sensations can be absent, therefore patients often do not perceive a problem seriously and postpone a campaign to the doctor.
According to statistics, this pathology often occurs in women, and athletes are also exposed to it. Often synovitis develops against a background of excess weight.
Depending on the cause that led to the development of the disease, the synovitis of the hip joint can be of several kinds:
- Infectious. This type occurs when the inner membrane of the joint bag is damaged by pathogenic microorganisms. And they can get not only directly from the external environment into the hip joint, but also from other foci of infection along with lymph or blood.
- Traumatic. It develops as a consequence of severe trauma, because of which the synovial membrane can not fully perform its functions. As a result, it begins to produce a large volume of liquid, it can not be used by the body completely and therefore accumulates in the joint cavity.
- Transit. This type of synovitis often develops in adolescents under 15 years. The cause may be a large load on the hip joint or a transferred viral disease.
- Reactive. It is also called allergic, as it occurs in response to inflammation in other tissues and organs of man.
- Chronic synovitis of the hip arises when the treatment is incorrect or even absent.
According to the nature of the secreted fluid, the synovitis can be:
- Adhesive, or serous-fibrinoid.
The latter form is the most dangerous, since it can cause infection of the whole organism. It develops due to the penetration of microorganisms into the joint bag. As a result, the synovial fluid becomes turbid, yellowish, nearby tissues swell, accumulation of pus occurs.
The peculiarity of purulent synovitis of the hip joint is that the liquid ceases to be released to the surface.
Doctors have not yet studied to the end what can become a trigger mechanism in the development of this pathology. But the most common causes of synovitis are the following conditions:
- Infection. Normally, the joint capsule acts as a barrier between the external environment and the joint. But if its integrity is compromised, a pathogenic microflora can enter. Staphylococci, streptococci, pneumococci, mycobacterium tuberculosis can cause inflammation. Pathways of penetration and spread are known to three:
- Hematogenous. Disease bacteria enter the joint capsule along with blood from other foci of chronic infections.
- Lymphogenous. The essence is the same as in the previous version, but microorganisms are spreading with a current of lymph.
- Contact. In this way penetration is possible in cases of damage to the skin through which pathogens that live on the surface and affect the surface of the synovial membrane of the hip joint.
- Traumatism. Most often, with injury, there is a rupture of the joint membrane. With minor damage, a bruise can form, which causes the development of the disease. If the injury was applied directly to the hip, this could even lead to bone fracture. With the indirect mechanism of damage, the impact is lower or higher than the joint, as a result, ligament rupture or hemarthrosis( accumulation of blood in the joint bag) may result, which causes the inflammation of the synovial membrane.
- Allergic reaction. The allergens to which the body is sensitive can also serve as a trigger for the development of synovitis of the hip joint. They can be infectious and non-infectious. The first include bacteria, as well as their toxins, parasites, fungi. Non-infectious agents can be home dust, animal hair, pollen, food, household chemicals.
- Diseases of other organs and systems. They can be hereditary, sexually transmitted or have any other way of spreading. These include bursitis, syphilis, gonorrhea, gout, hemophilia.
- Unstable joint operation. With any restrictions in the movement of the joint, irritation of the synovial membrane occurs.then it becomes the cause of the development of the pathology of the hip joint. Instability can be formed against a background of damage to the meniscus or articular surfaces, joint deformation, ligament insufficiency.
- Excess weight can also provoke a synovitis, because excess body weight creates a large load on the musculoskeletal system.then leads to permanent microtrauma ligaments and tendons.
It is possible to determine the pathology of the hip joint according to the characteristics characteristic of synovitis. Mobility decreases or disappears completely. Sometimes a patient not only hurts, but also sits. At the site of the inflammatory process, arbitrary muscle contractions are observed.
Pain may also be a concern, which usually occurs at night. This symptom is characteristic of the stage of disease progression. With an external examination, you can see flushing and edema of the tissues around the hip joint. In rare cases, there is a local increase in temperature.
If the synovitis develops in childhood, then limb fixation in the forced position is observed. The defeat is one-sided, the child complains of severe pain. The result can be an incorrect placement of the joint and a temporary disability of walking( lameness).
Diagnosis can only be established after a comprehensive examination of the patient, which includes a survey, objective data and instrumental research methods. The latter are the dominant in the diagnosis and to such include:
- Radiographic examination of the joint.that method is affordable, fast, inexpensive. It allows you to see the condition of the joint, synovial membrane, articular surfaces, determine the level of fluid. To establish the degree of neglect, both limbs are examined and a diagnosis is established on the basis of comparison.
- ultrasound allows you to see the thickness of the synovial membrane, measure the volume of exudate, determine the condition of the surfaces of the joint and surrounding tissues.
- Puncture of the joint. This method is the most reliable, because with its help you can take a small amount of effusion to study its composition. Thus, it is possible to detect the presence of infectious agents, pus, blood, fibrin. But this method of research is contraindicated in patients with diabetes mellitus.
It is possible to get rid of synovitis of the hip joint only through complex treatment. This problem is dealt with by an orthopedic doctor. To begin with, it is necessary to eliminate the cause that led to the development of the disease.
It is necessary to ensure the peace of the affected limb.
Then medication is prescribed. Used drugs that can destroy the pathogen: antibiotics, antifungal drugs. Also, anti-inflammatory drugs are prescribed. Symptomatic treatment is performed. Painkillers, antipyretic drugs may be used. Vitamins are often used.
Together with drug therapy, physiotherapy methods are used. Among them, phonophoresis, magnetotherapy, electrophoresis, high-frequency therapy.
In severe cases, the patient is shown surgical treatment followed by the use of pharmacological drugs and the passage of a course of rehabilitation.
The outcome of the disease is usually favorable. The functions of the affected joint are completely restored. But in the absence of treatment for the purulent form of synovitis of the hip joint, complications such as sepsis are possible.
It is possible to prevent the development of pathology. To do this, you should lead an active lifestyle, exclude constant stress on the joints, and if you have any problems immediately seek medical help.