Which doctor treats synovitis of the knee joint

Begin the treatment of synovitis of the knee joint immediately!

The synovitis of the knee is a disease in which the synovial membrane of the joint becomes inflamed and an excess fluid( effusion and exudate) is formed in it. When synovitis of the knee joint, treatment should be given due attention and seek medical advice from the .Most cases of synovitis are recorded in the knee joint as a result of injuries and infection( cuts and other injuries).In some cases, synovitis develops due to hemophilia, allergies, arthritis, or bursitis.
Sometimes doctors select a primary exudative knee synovitis that appears without visible trauma. In such cases, the cause may be a moving articular body, injured articular cartilage, a severed meniscus or joint instability due to static changes or deficiency of the ligament apparatus.

How to treat?

If you are concerned about synovitis, first of all you need to see a doctor for complex treatment. First, the doctor finds out the true cause of synovitis, because it determines how to treat the disease in each specific case. After determining the appearance of excess fluid in the joint cavity, the doctor prescribes corrective therapy, with which you can get rid of it. Treatment of the knee joint from synovitis is always discussed individually, since depending on the degree of damage and the nature of intraarticular secondary changes, conservative treatment or treatment with the help of surgery will be used.

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The onset of

treatment In acute knee joint synovitis, surgery is the first stage. It is necessarily accompanied by a full-fledged medical correction of tissue development in the joint and a course of restorative treatment.
With temporary( transient) synovitis at the beginning of treatment, joint puncture and evacuation of intraarticular fluid are performed, as well as stabilization of the knee joint with the help of a knee or pressure bandage.
Some cases require more rigid stabilization of the damaged joint, for example, by applying a tire. In such cases, the diseased leg can not be loaded for 5-7 days, in parallel, a course of hypothermia( therapeutic effect of cold) is performed. For a longer period of time immobilization of the limb is undesirable, since complications such as joint stiffness may occur.

Pathogenetic treatment

Chronic knee synovitis is treated with medications that neutralize the underlying causes of the disease. With this diagnosis, salicylates, indomethacin, brufen, rumalon, heparin, achimotripsin and glucocorticoid medicines are effective. It is also recommended to use physiotherapy, it is prescribed from the third day of treatment. Chronic synovitis is effectively treated with magnetic therapy, UHF, heparin electrophoresis( lazonil or kontrikal) and phonophoresis of corticosteroid hormones. It should be noted that with a chronic synovitis it is dangerous to engage in self-medication, so consult a doctor so that he can write out the most effective medications.
Speaking of heparin, although it shows high efficiency, it can not be used at an early stage of the disease( for example, immediately after an injury), as it can provoke severe bleeding near the injured knee joint.
Diagnosis of "chronic synovitis" can be avoided if during an acute period to begin treatment with a specialist in a timely manner.

Treatment of chronic synovitis

If the synovitis of the knee joint has passed into the chronic stage, which is accompanied by a constant presence of effusion during relapse, as well as abundant infiltration of the synovial membrane. In such cases, doctors prescribe inhibitors and proteolytic enzymes, for example, hyaluronidases, proteinases, lysozyme, etc. In addition, preparations can be prescribed that are aimed at stabilizing the lysosomal membranes, designed to reduce their permeability. For this purpose, counterkal or traciol may be used, they are taken by courses, between which a few days of the interval are mandatory.
To affect the enzymes of lysosomes and reduce their permeability, small doses of corticosteroids may enter the list of necessary drugs. For example, hydrocortisone emulsions, dexazone, Kenalog 40 and other medications. Such intra-articular treatment has a strong antiproliferative and anti-inflammatory effect, due to which the synovial environment in the affected joint quickly returns to normal.

Surgical treatment

In some cases, chronic synovitis can not be treated with conservative therapy, then surgery is necessary. Surgical intervention is also shown when the patient in the synovial membrane found irreversible processes: the formation of hypertrophic villi and petrificata or sclerosis.
Depending on the severity of the synovitis of the knee joint and how widely the inflammation has spread, the operation of the synovectomy may be partial, subtotal or total. During the operation for the treatment of synovitis, a cavity of the knee joint is opened with a cut of the type of Payra. In the process of surgery, the surgeon removes deformed menisci, foreign bodies, examines the integumentary cartilage and excises the synovial membrane transformed by pathology.
In the post-operation period hemostatic, anti-inflammatory therapy is prescribed, as well as thorough hemostasis. The patient's leg is placed on the Béler's niche and is not loaded for several days after surgery. After surgery, complications such as contracture of the knee joint or synovitis recurrence are possible.
Synovitis can be treated not only by the above methods, but also with the help of folk methods. To find such recipes, you can go to the forum dedicated to folk medicine. Using the forum, do not forget that recipes of folk remedies should help cope with the disease, and not cripple. Therefore, it is important to remember that the use of folk methods is important to discuss with a specialist, he will tell you what is best for you in your case of synovitis and what recipes should be abstained.

pozvonkoff.ru

Synovitis of the knee joint: why it arises and how to cure it

Synovitis is a disease characterized by inflammation of the synovial membrane of the joint, followed by the formation of effusion and exudate( excess fluid) in it. In most cases, synovitis affects the knee joint, since the main cause of its development is trauma( ie, posttraumatic synovitis develops), infection as a result of injuries, cuts or abrasions. In addition, synovitis can easily develop against a background of hemophilia, bursitis, allergies or arthritis.

Also, exudative knee synovitis can occur without visible trauma( the so-called primary synovitis), as a result of irritation of the synovium by a moving articular body, injured articular cartilage, torn apart meniscus, or as a result of joint instability due to insufficient ligament apparatus or static changes.

More information on the causes of synovitis and its symptoms can be found in the article Synovitis of the knee joint and how it manifests itself.

How to cure the disease

Treatment of synovitis of the knee should be comprehensive, and the choice of method of treatment directly depends on the causes of the disease, the stage of the disease and the nature of its course. First of all, the causes of the appearance of synovial fluid in the knee joint are determined, and corrective therapy for its elimination is carried out. The question of conservative or operative intervention is solved individually, in each case, based on the severity of the damage, the nature of secondary changes within the joint and other causes.

The first stage of treatment

Surgical intervention is considered as the first stage of treatment of acute synovitis, which, without fail, is accompanied by a full course of medical correction of intraarticular tissue disorders, as well as effective treatment aimed at restoring the patient.

knee bandages help to stabilize joint with synovitis

The primary stage of treatment of transient synovitis involves joint puncture with the evacuation of the synovial fluid and the stabilization of the joint, using a special pressure bandage or knee.

In some cases, it may be necessary to stabilize the patient's joint more severely with tires. The patient should not load a sick limb for 5-7 days and the first few days to undergo a course of hypothermia - cold treatment. Long-term immobilization without visible indications is undesirable, as this may be the result of complications such as joint stiffness.

Pathogenetic Therapy

The effective methods of pathogenetic treatment of chronic synovitis of the knee joint include the use of special medications, whose action is aimed at neutralizing the underlying causes of the disease. These drugs include: indomethacin, salicylates, rumalon, brufen, heparin, preparations of glucocorticoid action, achymothripsin. It is also recommended, on the third day of therapy, to additionally use physiotherapeutic methods of treatment. Effective will be magnetotherapy, heparin electrophoresis, kontrikal and lazonil, UHF, phonophoresis of corticosteroid hormones.

Please note: the names of the drugs and methods of treatment are indicated for informational purposes only. To get the right treatment, do not try to take the medication yourself, see a doctor!

Although heparin is a fairly effective drug, it is contraindicated in the early stages of treatment, immediately after trauma or surgery, since the drug can cause severe bleeding in the joint area.

If the acute period of the disease in a timely manner to begin complex treatment, the development of a chronic form can be avoided.

Treatment for chronic disease

treatment of this disease should be prescribed only by the doctor

In the chronic form of synovitis, accompanied by constant effusion in the recurrent stage and abundant infiltration of the synovium, it is recommended the use of inhibitors of proteolytic enzymes: lysozyme, proteinase, hyaluronidase and others. In addition, the patient can be assigned funds aimed at stabilizing the membrane of lysosomes and reducing their permeability. As such stopping factors apply tracerol or contra-kali courses with an interval of several days.

The inhibitory effect on lysosomal enzymes and the reduction in their permeability can also be caused by the use of minor doses of corticosteroids, such as dexazone, hydrocortisone emulsions, Kenalog 40 and the like. Thus, intra-articular therapy expresses a strong anti-inflammatory and antiproliferative effect, in the shortest time brings the synovial environment of the affected joint back to normal.

Operation

In the chronic form of synovitis, which is not amenable to treatment, and the ineffectiveness of conservative therapy, and also if there are irreversible processes in the synovial membrane - for example, sclerosis, the formation of hypertrophic petrifications and villi, surgical intervention is indicated.

sometimes with synovitis of the knee operation is required

The operation consists of a partial, total or subtotal synovectomy, depending on the severity and extent of the inflammatory process. Surgical intervention is performed by opening the cavity of the knee joint with the help of a cut of the Payra type. During the operation, foreign bodies, deformed meniscuses are removed, the cover cartilage is examined, the pathologically transformed synovial membrane is excised.

The postoperative period is accompanied by hemostatic and anti-inflammatory therapy, thorough hemostasis. The diseased limb is placed on the Béler niche and remains unloaded for the first few days. Post-operative complications include joint contracture and relapse of the disease.

In addition, there are various methods of treatment with folk remedies, but it should be remembered that the use of such recipes must necessarily be discussed with the attending physician.

ArtrozamNet.ru

Effective treatment of chronic and reactive synovitis of the knee joint

Any joint of the human body is covered with a synovial membrane, the main function of which is to prevent friction between two adjacent articular surfaces. As a result of inflammation of of this membrane, the amount of fluid in the joint bag significantly increases, this disease is termed synovitis.

The synovitis of the knee joint most often develops, it is connected with the increased load on this part of the body.

Causes of

Inflammation of synovial membranes arises under the influence of internal and external adverse factors; in most patients, has been determined by to have the effect of :

  • Injury.
  • Infection.
  • Autoimmune diseases.
  • Metabolic disorders.
  • Allergies.

The synovitis of the knee may also be a secondary manifestation of such a disease as arthrosis.

Symptomatic manifestations of

Disease A gradual increase in symptoms is noted. First, there is swelling of the knee, then its slow increase in size. Knee deformation indicates the accumulation of fluid in the joint bag. In the knee joint movement is limited, up to the impossibility of completely bending it. As the fluid increases, pain appears, when it is dull, there is no strong intensity.

Diagnostic sign of disease is a puncture , that is introduction into the joint area of ​​a syringe with a needle and pumping out the exudate. With synovitis, the secret will be without blood components, a laboratory analysis is conducted for the presence of microflora and various impurities.

You can find out more about the prevention and treatment of a disease such as hip synovitis in our article.

Find out what ointment from the calcaneal spur has helped not one hundred people you can here. Also you will find all the necessary information on the treatment of this unpleasant disease.

Classification of the disease

It is customary to classify the synovitis due to the origin, nature of the course.

Because of the onset of , the synovitis is divided:

  1. Infectious synovitis develops under the influence of pathogenic microflora. The infectious agent can penetrate into the joint bag when injured from the external environment, from distant foci of infection with blood flow or from a number of located abscesses. Infectious inflammation cause streptococci, staphylococci, pneumococci, less often a tubercle bacillus, pale treponema( with syphilis) and other microorganisms.
  2. Aseptic synovium t - in this form of inflammation of pathogenic microflora in exudate is not detected, the disease is reactive and occurs under the influence of injuries, due to irritation of the membrane with torn meniscus or damaged cartilage, endocrine disorders, hemophilia.
  3. Allergic synovitis develops under the influence of a wide variety of allergens.

According to the nature of , the synovitis is divided into:

  1. Acute - develops in a few hours or days after the influence of the provoking factor. For this form all symptomatology of the disease is characteristic, sometimes it is possible to fix febrile syndrome.
  2. Chronic synovitis appears after not cured acute. It is characterized by periodic accumulation of fluid, frequent exacerbations lead to degenerative changes in the joint and to extension of the ligamentous apparatus. Treatment of chronic synovitis of the knee is the most difficult and protracted.
  3. There is a separate form of synovitis - reactive .There is a reactive synovitis already because of the existing problems with the joint and most often it is arthritis.

Complex therapy for

The treatment of synovitis of the knee joint should be complex , with a moderate amount of effusion the patient is treated on an outpatient basis. The definition of the entire treatment regimen of

depends on the underlying cause of the disease, the degree of joint deformity and the restriction in movements, the phase of the disease.

The main stages of treatment

  1. Comprehensive examination. The doctor needs to find out the main cause of the disease - the presence of injuries, a number of located abscesses.
  2. Puncture .Be sure to take the synovial fluid for the study, a precise definition of the pathogen will help determine the appointment of drug therapy. Pumping fluid partially relieves pain and restores mobility to the joint. Puncture is practically painless, it does not require anesthesia.
  3. Immobilization. Ensuring the immobility of the joint is an important stage in the treatment of synovitis. For temporary immobilization choose a pressure bandage, the imposition of tires or gypsum longes. The period of immobility is usually a week or slightly more.

Medication Therapy

Drug therapy with synovitis is the most important guarantee for the absence of exacerbations in the future, and the appointment and use of drugs from different groups prevents the destruction of the surfaces of the knee joint.
  • Anti-inflammatory nonsteroidal drugs are prescribed for the purpose of relieving inflammation. Under their influence, the amount of effusion decreases, and painful sensations decrease. Usually, a tablet or injectable preparation and an anti-inflammatory ointment are prescribed. To NVP include Diclofenac, Ketoprofen, Naise, Diklak .In the treatment of synovitis of the knee joint, ointment Voltaren, Ketonal, Indomethacin , Collagen Ultra gel is widely used. NVPVs irritate the mucous membrane of the digestive organs, so patients with peptic ulcer are recommended to use them in rectal suppositories, which also possess all the effects of other forms of drugs.
  • Inhibitors of proteolytic enzymes are drugs that prevent degenerative changes and reduce the amount of exudate. Their use is also necessary in the chronic stage of the disease. These drugs include Gordoks, Trasilol, Kontrikal .Drugs are injected intravenously or used as capsules.
  • Antibiotics are used for infectious or heavily flowing reactive synovitis. They are injected into the joint cavity or used as intramuscular injections. Assign Ceftriaxone, Metrogil,
  • Corticosteroids are used for a seriously leaking disease. The use of hormonal drugs effectively removes inflammation, which reduces pain. Use Dexamethasone, Kenalog - 40.
  • Microdermal regulators are necessary for normalization of metabolic processes and improvement of nutrition of joint tissues. Assign vitamin PP, ATP, Trental, Heparin.
  • Vitamin - mineral complexes are used. Their use improves microcirculation, increases the production of collagens.

Physiotherapeutic procedures

The use of physiotherapeutic procedures with synovitis allows to partially reduce pain, prevents further inflammation, positively influences the mobility of the joint. uses currents of different frequency, magnetotherapy, UHF, electrophoresis with the necessary drug .Physiotherapy procedures are usually prescribed by a doctor approximately on the third day after the onset of the disease.

Treatment for the chronic form of the disease

In the treatment of chronic synovitis of the knee joint , in the acute stage of , drug therapy is also prescribed and joint puncture is performed with the introduction of a drug substance into its cavity. With a long and often recurring process, a decision is made to perform

Surgical intervention is necessary in the absence of the effect of the current therapy regimen. If there are extraneous inclusions in the joint cavity - the meniscus, parts of the cartilage or bone, surgical intervention is performed in the acute form of the disease.

In case of prolonged chronic course, the operation is necessary if there are data on irreversible pathological processes in the membrane - sclerosis, build-up of villi on the spongy substance.

Without surgery, prolonged flow can lead to complete relaxation of the musculoskeletal system, in which the main function of the knee joint is lost.

Operation procedure is simple - make a cut over the joint, get into the synovial cavity and assess its condition. If foreign elements are present, they are removed, and the altered synovial membrane is excised. After surgery, the limb is immobilized, it is recommended to begin movement without load on the third day after surgery. After the operation, several days of hemostatic and antibacterial therapy are used.

Folk remedies in the fight against the disease

Folk treatment of synovitis of the knee joint with the help of popular recipes should be carried out only in combination with the main therapy, grandmother's recipes also benefit in the chronic course of the disease.

Well restores disturbed metabolism and prevents the emergence of further pathological processes following prescription:

  1. It is necessary to mix dry raw materials of thyme, eucalyptus, echinacea, tansy, birch leaf, mistletoe white. To prepare the infusion it will take one spoonful of a mixture of herbs and a glass of boiling water. Drink the resulting broth during the day for 1 before eating.
  2. The therapeutic effect on the affected joint is provided by a self-prepared ointment. The crushed comfrey root is mixed with an equal amount of ordinary lard. With the mixture obtained, the affected joint is lubricated up to 3 times a day, and the effect of applying the dressing on top increases.

The knee joint under synovitis experiences an increased load, so a decrease in its own weight will also have a positive effect on overall well-being.

Prognosis for

Patients with synovitis often return to the treating physician for exacerbations. In this case all treatment is carried out anew. The absence of secondary relapses of the disease depends on compliance with all proposed treatment methods and preventive measures.

High efficiency of treatment is observed in allergic and aseptic synovitis. With purulent synovitis, the formation of contractures is possible, in the most severe cases there is a sepsis .

Video: Gymnastic exercises for knee joints

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Synovitis of the knee joint: treatment. How to get rid of the chronic form of the disease?

The knee joint is the largest in the human body and, at the same time, the most vulnerable: after all, it is constantly subjected to loads during movement and carries a body weight. One of the most common diseases of the knee joint is synovitis. The disease consists in inflammation of the synovial membrane of the joint and the violation of fluid circulation between the ligaments and bones. Symptoms and signs of synovitis is extremely difficult to distinguish from similar inflammatory diseases.

Therefore, confirmation of the diagnosis should occur after careful diagnosis, and therapy is conducted under supervision and with the participation of a specialist.

Symptoms of

Symptoms of synovitis usually do not appear until the second day after the start of the process of inflammation of and are expressed as follows:

  1. pain in the knee of the aching species, which can last continuously or annoy periodically;
  2. difficulty in bending the knee;
  3. sensation of numbness in the joint region, or the entire leg.

Signs of the disease

An obvious sign of the development of synovitis in the knee joint is swelling and deformation of the affected area due to the accumulation of excess fluid, sometimes with an admixture of pus, in the synovial membrane.

In this case, reddening of the skin and increased body temperature is not observed. An exception is the infectious form of synovitis, in which the temperature rises sharply, the knee turns red and literally increases in size.

Causes of

In most cases, synovitis is a consequence or complication of already of the existing disease - gout, arthritis or artose - that is, the one with increased pressure on the knee joints and synovial bags.

There is a reactive synovitis. The disease can also be traumatic, purulent or chronic. And to other reasons of its occurrence carry:

  • Infectious diseases in the anamnesis after which the infection could pass to the knee joint region;
  • Impaired immune system;
  • Hemophilia;
  • Entry into the joint region of bacteria of the family streptococcal, staphylococcal and similar through cuts, abrasions;
  • Various knee injuries( ligament or meniscus damage, internal hemorrhage, fractures of the joint bones) and their consequences.

Treatment with a conservative method

The procedure for treating synovitis directly depends on the causes that caused of disease.

To identify these causes, a puncture( puncture) of the synovial pouch of the joint is applied. This procedure is painless, so there is no need for anesthesia.

The joint is pierced with a special thin needle, the synovial fluid is taken away and sent to the laboratory for analysis.

The most important point in the treatment of synovitis, which is applied regardless of the type of disease, is the immobilization of the joint, i.e. creating conditions for its immobility.

For this purpose a special knee or pressure bandage is used. In acute synovitis with a severe purulent lesion of the joint, a gypsum langette or even a tire is applied.

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The average period of immobilization is from 5 to 7 days. Drug medications during wearing dressings are appointed individually, depending on the causes of the ailment and the patient's well-being.

So, for the removal of pain and suppress inflammation, anti-inflammatory agents are prescribed non-steroidal ( eg Ketonal).And with malignant and severe forms of the disease, it is steroid drugs, directly into the affected joint.

Inhibitors( Gordox, Traxiol) are prescribed with the chronic form of synovitis with a large amount of excreted effusion. Treatment with inhibitors is always conducted in courses. Antibiotics are indicated to all patients who underwent puncture to avoid accidental introduction of a secondary infection.

And if the disease itself is triggered by infection with , then a dose of antibiotics is increased, or it is recommended to take stronger medications.

Treatment with pharmaceutical and folk ointments

In synovitis therapy ointments with anesthetic effect are used - Fastum-gel, Voltaren, Diclofenac, Indovazin, Diklak, etc. If abrasions and wounds are present in the knee region, they are treated with with antiseptics and heparin ointment. All these funds are available on a free sale in almost every pharmacy.

But an effective ointment can be done with your own hands, borrowing recipes from traditional medicine.

grasshopper ointment has high efficiency. To produce it, you need to take a full glass of grass and 200 grams of pork tenderloin. Mix and put in the refrigerator for 5 days, after which you can use - rub twice a day in a sore knee.

Smear the joint with synovitis useful and with bay oil .It is necessary to crush laurel leaves in an amount of 2 tablespoons and pour them with any vegetable oil.

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Leave to soak for a week, after which rub in the joint area three times a day. Folk ointments from synovitis due to their long preparation are suitable for the treatment of chronic disease, or as an excellent restorative after a joint operation.

Treatment with surgical method

In a situation where traditional methods of treatment did not produce the expected result, and the patient's condition did not improve, and irreversible changes were found in the synovial membrane, then they resort to surgical intervention. Partial, and all the more total synovectomy is extremely rare, and it usually occurs in severely neglected stages of the disease.

The operation consists in opening a synovial bag, removing pus, foreign bodies and damaged meniscuses. The disinfection of the integumentary cartilage is performed, and the synovial membrane itself is removed.

After the operation or the usual course of conservative treatment of synovitis, patients are prescribed medicated medications, as well as attending courses of physiotherapy exercises to develop the joint and restore the former mobility.

MedicKon.com

The entire surface of the ligaments and joint cavity, except for the cartilaginous areas, is covered by the synovial membrane. It consists of vessels and nerves, provides nutrition to cartilage of the joint, promotes normal metabolism in the joint cavity and acts as a kind of shield for the joint.

Synovitis of joints is an inflammatory process that occurs in the synovial membrane. This disease is characterized by an increased accumulation of fluid in the joint cavity. Most of the synovitis suffer from ulnar, hip, wrist, ankle and knee joints. The last variant will be discussed in this article, we will consider in more detail the chronic form of the synovitis of the knee joint, the causes of its development, the characteristic symptoms, as well as the methods of diagnosis and treatment.

Causes of

Synovitis of the knee joint can develop after severe trauma, be a consequence of acute rheumatism and other infectious pathologies, tuberculosis, syphilis, inflammatory processes that occur near the joint area. Also, the disease often occurs against a background of various disorders of the endocrine system and neurological pathologies.

If a person suffers from hemophilia, he often has hemorrhages in the joint cavity, which also act as provocateurs of the disease.

Risk factors also include fractures of the joint bones and meniscus irregularities.

Chronic synovitis of the knee joint is not as common as other forms of this pathology. For the most part, it is the result of incorrect and untimely treatment of the acute form of the disease. It can also be the result of a latent and sluggish inflammatory process in the body.

Symptoms of

In the initial stages, the chronic synovitis of the knee joint in patients of childhood and adulthood manifests rather insignificantly. As a rule, patients have only general signs of the disease, namely:

  • there is a strong fatigue, the patient quickly gets tired while walking;
  • there are slight restrictions of movements in the affected joint;
  • is painful, the pain is aching.

In addition, one of the typical manifestations of chronic synovitis is constant swelling in the knee. Edema develops due to the fact that the articular fluid does not have time to resolve due to the incessant irritation of the synovial membrane.

Thus all elements of a knee can not execute the functions, as a result there is a gradual destruction of a joint. At the same time, the patient's state of health deteriorates: puffiness becomes more pronounced, with painful sensations and a vascular network in the knee area.

Diagnosis

Such a diagnosis as a synovitis of the knee joint can not be established solely on the basis of anemia, as well as patient complaints and examination results, for its confirmation it is necessary to conduct an instrumental study. This is because most of the clinical manifestations( such as pain and movement disorders), and objective data( ie, the presence of swelling of the joint, redness of the skin over it, swelling) are nonspecific and can occur with different diseases.

Therefore, when establishing the diagnosis, the physician should be guided by the data of some instrumental diagnostic methods:

  • Ultrasound examination - this method is quite informative, it helps to detect the effusion in the joint cavity. For example, if the amount of exudate is more than 1 milliliter, it will already be visible. You can also use ultrasound to determine how thick the joint capsule is.
  • Magnetic resonance imaging - this type of research helps visualize intra-articular structures. It is based on its indicators and the diagnosis of "synovitis."With this pathology, one can note the change in signal intensity in the joint cavity due to accumulation of exudate. When carrying out magnetic resonance imaging with contrast, the signal from the inflamed synovial membrane will be amplified, and its proliferation hanging in the lumen of the capsules of the joint capsule is also noticeable.

Treatment of

In the process of treatment of chronic synovitis of the knee joint, quite a few good medicines have been observed. The following medicines are used for this pathology:

  • Anti-inflammatory nonsteroidal agents - well eliminate pain, reduce inflammation. And the drugs of this group are produced in the form of injections, tablets, ointments and suppositories, so that you can achieve better results in treatment. In a number of situations, doctors prescribe the use of drugs in a rectal way - candles reduce the load on the gastrointestinal tract, but have no less efficacy than tablets. In the form of tablets and suppositories, such means as Diklak, Nyz, Analgin, Ketonal are quite popular. Outwardly on the joint area, ointments and gels are applied: Indomethacin, Ketonal, Voltaren and Diclofenac.
  • Inhibitors of proteolytic enzymes - this group of drugs is especially indicated for the treatment of chronic synovitis of the knee joint. At this stage, the disease occurs with a large amount of effusion, there is infiltration of the affected joint. Treatment is carried out by courses - the means must be administered intra-articularly after the puncture. The following medicines are used: Trasilol, Gordoks.
  • Corticosteroids - used in the case of very serious forms of the disease. Steroids - Dexamethasone and Kenalog-40 are injected into the joint.
  • Microcirculation regulators - to restore normal microcirculation, which was disturbed by the pathological process, doctors prescribe nicotinic acid, adenosine triphosphate acid, Tiatriazolin and Trental.
  • Antibacterial drugs - after the puncture, the doctor injects antibiotics into the cavity of the affected joint. In this case, those drugs that use a wide spectrum of action are used. Antibiotics help prevent the attachment of a secondary infection in the case of a confirmed bacterial nature of the disease.
  • Biologically active additives - if necessary, prescribe vitamin-mineral complexes as an auxiliary therapy.

In addition to the use of medicines, the treatment of synovitis of the knee joint includes systematic performance of special exercises and treatment with physiotherapy procedures. True, the effect of such manipulations will only be if the pathology is not strongly pronounced.

In case of prolonged form of chronic synovitis and with unsuccessful conservative treatment, in the presence of irreversible changes in the synovial membrane( for example, sclerosis, the formation of hypertrophic villi, petrificata and others), surgical intervention is indicated. An operation is performed - subtotal, partial or total synovectomy, depending on the degree of severity of the pathological process.

During the surgical intervention, the surgeon layers the cavity of the knee joint layer by layer. The revision, removal of foreign bodies damaged by the meniscus, also covers the cover cartilage. The pathologically altered synovial membrane is excised. It is quite easy to separate the latter from a fibrous capsule. Also, there is no difficulty in removing the synovial membrane from the upper curvature, it is more difficult to do this from the upper-lateral curvature, it is quite problematic to excise it from the posterior and lateral lateral twists.

After the synovectomy, careful hemostasis, anti-inflammatory and hemostatic therapy is necessary. The diseased limb is fixed with the help of the Belera bus, it is recommended to start early movements( without heavy loads) from the third to the fourth day after the intervention. Among the possible complications after the operation can be called the appearance of co-tracts, as well as repeated manifestations of the disease.

Which doctor treats

If there is a suspicion of this pathology, you should consult a trauma doctor. Surgical interventions are performed by surgeons.

In conclusion of the article I would like to say a few words about the prevention of synovitis. So, to prevent the emergence and development of the disease, you need to timely eliminate all inflammatory processes in the body, and also try not to allow traumatic effects on the joints.

knigamedika.ru

Synovitis of the knee joint: symptoms, treatment, diagnosis, classification |The ABC of Health

Any joint damage that traumatises the synovial membrane. There are two types of injuries:
  • Straight - impact directly on the joint( drop on the knee, hit the specified area);
  • Indirect - damage to the knee joint when exposed to other areas of the body( sharp body / hip rotation with a fixed foot).
Acute infectious synovitis When the bacterium enters the synovial membrane. This can occur:
  • With open injuries( penetrating injuries, open fractures);
  • After puncture of the knee joint.

The spread of infection through the blood or lymphatic pathway is rare.

Chronic synovitis This form is observed in chronic joint diseases or metabolic disorders. It is inherent in the following diseases:
  • Osteoarthritis - non-infectious joint damage, in which its gradual destruction occurs;
  • Arthritis( rheumatoid, psoriatic, tubercular and so on) - infectious or postinfekionnye diseases of joints;
  • Gout is a violation of the exchange of uric acid, which causes the deposition of its salts in the joint and inflammation of the synovial membrane.
Migrating synovitis Arises from rheumatic fever.
Insect-nodular synovitis( synonyms - pigment, vinylonodular) This is a very rare form of the tumor, in which the cells of the synovial membrane grow. The exact cause of development is unknown.

If it is not possible to determine the cause of the disease reliably, the doctors indicate the "unspecified synovitis" in the diagnosis.

Symptoms of

Symptoms of synovitis of the knee joint do not depend on the cause of development( the exception is acute infectious synovitis).They are determined by the duration of the course and the severity of the pathological process. Therefore, they consider the acute and chronic forms independently of each other.

Symptoms of acute synovitis

The main symptom of this form is the rapid appearance and growth of symptoms. First of all, there is pain. It has the characteristic features:

  • extends to the entire joint area, and is not limited to a specific point;
  • as a rule, the pain syndrome is quite intense;
  • pain intensifies in the morning, and towards evening weaken( due to the development of anti-inflammatory hormones);
  • at rest is only slightly weaker.

Soon after the onset of the pain syndrome, a "swelling" in the joint area may be formed, due to increased production of intra-articular fluid. Active movements in the joint are slightly limited( by 10-15o), since full extension / flexion increases pain.

If the patient has an acute infectious synovitis, signs of intoxication may be added to local symptoms: fever( up to 37-38 ° C), weakness, headache, loss of appetite. In the absence of adequate treatment, bacterial synovitis can lead to the development of phlegmon of the knee joint.

Symptoms of chronic synovitis

Unlike the acute form, chronic synovitis proceeds with periods of exacerbations and remissions( disappearance of symptoms).The pain syndrome, in the first few years from the onset of the disease, is almost the same as in the acute form. However, in the subsequent, the gradual destruction of the articular cartilage starts, the ligaments weakens, the capsule of the joint becomes thinner. This leads to:

  • pain intensification;
  • significant restriction of movements in the knee joint;
  • "instability" of the joint - dislocation in these patients will occur much more often.

Fever is not characteristic of a chronic form. In the period of exacerbations, it is possible to raise the temperature to 37 ° C.With adequate treatment, the patient has only symptoms of moderate synovitis, which practically does not reduce the quality of his life.

Diagnostics

After collecting complaints, you may suspect the presence of synovitis. To determine the form, it is necessary to pay attention to the presence of the causes of the disease in the patient's past. However, to confirm the diagnosis, an additional examination is necessary: ​​

  • Blood tests:
  • in the general blood test, you can find signs of inflammation: an increase in the number of leukocytes( more than 9.0 * 109 / L), an increase in ESR( above 15);
  • in biochemical analysis should pay attention to the C-reactive protein. Its significant increase( more than 10 ng / ml) is an indirect sign of immune inflammation( rheumatic or psoriatic synovitis);
  • in serological analysis can be determined antibodies to streptococcus( antistreptokinase, ASLO, anti-streptogialuronidaz) - this is a reliable sign of rheumatoid or migrating synovitis.
  • Fluorography - to exclude tubercular synovitis( however, it often occurs in "pure" lungs as extrapulmonary pathology);
  • Radiography( in two standard projections - direct and lateral) of the affected joint;
  • Arthroscopy - performed in difficult diagnostic cases. During this procedure, the doctor makes an incision and inserts a camera with a flashlight into the joint cavity. Often, if a pathological focus is detected, the doctor will treat "on site".

Confidently confirming the presence of synovitis and its shape, you can determine the tactics of treatment.

Treatment of

How to treat synovitis of the knee joint? It depends on two main points: the causes of the appearance of the disease and the mechanism of its development. If the doctor can get rid of these factors, the synovitis for the patient will remain in the past. Unfortunately, there are a number of diseases in which it can not be cured forever. These include:

  • osteoarthritis;
  • rheumatoid and psoriatic arthritis;
  • gout and some others.

For each form of synovitis, treatment regimens have been developed that allow the return of normal joint function or maintain the patient's quality of life at the proper level.

Treatment of acute traumatic synovitis

The treatment regimen for this form of synovitis can be roughly divided into the following points:

  • Treatment of trauma - if this is an open fracture, the surgeon restores the normal position of the bones inside the joint, stitches the damaged ligaments and capsule sites( if damaged) and sutures the skinover the wound;
  • With intraarticular fractures( closed or open), the patient must be placed on "skeletal traction" - through the bones that form the joint, pass the spokes and hang the weight so that there is no re-displacement. As a rule, this stage lasts about 3 weeks if an operation has been performed;
  • If symptoms of synovitis occur at any time, the patient is prescribed:
  • Non-hormonal anti-inflammatory drugs( NSAIDs) intramuscularly or in the form of tablets. Most commonly used: Diclofenac, Ketorolac( Ketoprofen, Ketorol), Ibuprofen, Nimesulid( Naise);
  • To eliminate side effects( the formation of gastric ulcers and duodenal ulcers), together with any NSAIDs, prescribe "proton pump inhibitors" - omeprazole, rabeprazole and so on.
  • For the period of "skeletal traction" the patient is given physiotherapeutic procedures( in Russia it is magnetic or phototherapy), which accelerate the healing of tissues. They also have an anti-inflammatory effect, reducing the severity of synovitis;
  • If there is a significant swelling in the knee or examination methods, a large amount of fluid is found inside the joint, the patient is punctured and excess volume is removed.
  • After removing the knitting needle, the damaged leg is gypsumed for at least 6-8 weeks. During this period, synovitis is rare enough. And even if it occurs, it can be detected only by removing the plaster bandage. Treat according to the above scheme.

Is it worth using an NSAID ointment? At present, it is widely believed that ointments act better than tablets or intramuscular injections with NSAID preparations, since they are applied directly to the affected area. Recent clinical studies have shown that this is misleading. All NSAIDs act on an enzyme that promotes the formation of inflammatory substances, regardless of the site of administration. Ointments have the worst absorption, from the listed forms, therefore they are not recommended to apply now.

On average, the symptoms of synovitis, with adequate treatment, go through 5-11 days.

Treatment of acute infectious synovitis

With this form, in addition to the excess fluid, pus and bacteria exist inside the joint, which gradually destroy the cartilage, ligaments and capsule. Therefore, it is important to perform puncture of the knee in a timely manner with the introduction of disinfecting solutions.

How is the puncture of the knee joint performed? No preparation is required from the patient. The puncture area is first treated with alcohol( 70% solution) twice, then with iodine solution. After this, topically anesthetize the skin with lidocaine or novocaine and make a puncture. First, the contents of the joint are pumped out, then it is washed with an antiseptic and repeatedly pumped until the purulent contents are completely removed.

After a puncture, prescribe antibacterial drugs and NSAIDs. Anti-inflammatory therapy is similar to that of an acute traumatic synovitis. Antibiotics prescribe penicillin series or macrolides. They have the best effect with minimal amount of side effects. The following preparations are shown:

zdravotvet.ru

How to treat inflammation of the joint-synovitis

Marina Goryacheva

SYNOVIT - inflammation of the synovial membrane of the joint with the formation of effusion in it. The knee joint is most often affected. Distinguish between acute and chronic synovitis. In acute synovitis, pain, increased local temperature, effusion in the joint are observed. Chronic synovitis is characterized by unsharp pain, a periodic accumulation of effusion in the joint;with prolonged existence develops deforming arthrosis. The diagnosis is clarified by examining the fluid obtained from joint puncture( the kind of cells, crystals, the amount of protein, microflora).In addition to the therapy of the underlying disease, puncture of the joint is applied, a pressure bandage is applied, immobilization of the limb is made with a gypsum lantabe, physiotherapy is prescribed. When acute synovitis treatment is carried out in a hospital. For the removal of inflammation, various non-steroidal anti-inflammatory drugs can be used. To clarify the nature of the disease and the most effective method of treatment, you need to contact an orthopedic specialist.

Tim

The causes of synovitis in all people are different. The cause of synovitis may be very far from the knee joint and, at first glance, not to have anything to do with this joint.
But it's not. For example, the causative agent of synovitis( infection) may be in the large intestine and, if it is not found and not treated, no other treatment will help. The reasons can be several dozen and for each of the reasons there are methods of treatment. For example, the cause can be various infections, either a disruption of the thyroid gland, or parasitic invasion, or accumulation of uric acid, etc. Synovitis often occurs after joint trauma, as well as arthritis, allergies, hemophilia.
Important for synovitis - the knee joint must be firmly bandaged with a soft bandage.
Anti-infectious and anthelmintic agents must be present in treatment.
COMPOSITION: mistletoe white, yarrow, St. John's wort, oregano, thyme, echinacea, birch leaf, eucalyptus, bearberry, walnut, calendula, tansy, immortelle, celandine grass, crochet moss, valerian roots, calamus, althea, licorice. PREPARATION: table. Spoon the herbs( without top) with 2 cups of boiling water. To boil 2 minutes, to insist 1 hour, to filter. Take between meals, drink all the cooked infusion in several receptions throughout the day. The course of treatment is not less than 3 months.
As the strongest anthelminthic agent I recommend using black nuts tincture, which is used for any oncology and other diseases: blood, skin and infectious diseases, stomach, intestine and liver diseases, cleans blood and the body as a whole, expels parasites. Take tincture of 1 teaspoon 3 times a day for 20-30 minutes before meals.
Very often the occurrence of synovitis is preceded by traumas that are often overlooked or not taken into account, dislocations and cracks in the joints often contribute to the progression of the disease. In the folk healing, herbal treatment for the treatment of the consequences of injuries( splices of bones and joints), the comfrey medicinal is used. It is believed that the comfrey can be used with advantage in any bone pathology - damaged tissues quickly restore the epithelial cover where the necrosis process has already reached deep layers. Comfrey has the property of providing regenerative, bactericidal, anti-inflammatory, antitumoral, wound and bone-healing effects.
Comfrey roots are used fresh or dried. Fresh roots are very difficult to maintain - they quickly mold. Dried the same roots do not lose their healing power - they can be stored in a dry, well-ventilated room for a year! And use it when necessary.
For oral use, you can use alcohol tincture or decoction of the roots. For tincture: 1 part of ground roots into 5 parts of vodka. Insist 2 weeks. Take 20-30 drops 3 times a day. For broth: 1 tbsp.a spoonful of roots on a glass of boiling water. Do not boil! Insist in a thermos, strain and drink in equal parts throughout the day.
If you rub in equal proportions the roots of the comfrey with porcine unsalted fat - you will get a wonderful ointment for rubbing joints, fracture sites. You can also make compresses on sore spots: 2 tbsp.spoons of crushed roots into 2 cups of boiling water. Infuse the night in a thermos.
Treatment of synovitis comfrey, tincture of black walnut and anti-infection collection should be carried out in a comprehensive manner. Take tinctures and collection in parallel, with a break of 15-20 minutes, externally do compresses and use ointment. The course of treatment is long, at least 3-6 months.

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