Hip synovitis.

Synovitis of the hip joint is not as common as, for example, the knee or elbow, but it is necessary to know something about this disease.

The inflammatory process of the articular membrane with the release of exudative fluid into the hip joint is called synovitis.

Causes of synovitis of the hip joint

Synovitis of the hip joint can have aseptic or infectious etiology.

Aseptic disease develops as a result of:

• joint trauma (bruise, fracture, dislocation);
• allergic reactions;
• disorders of the endocrine system (diabetes mellitus, thyroid pathologies, gout);
• neurogenic causes (stress, neuritis, other nerve damage);
• autoimmune diseases, metabolic disorders or metabolism.

An infectious cause of synovitis is the penetration of pathogenic microbes (pneumo- and staphylococci, tuberculosis bacilli, etc.) into the joint cavity. Bacteria can enter the joint with the blood or lymph flow from other organs.

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Symptoms of synovitis of the hip joint

Symptoms of hip joint synovitis often appear late. At first, the patient begins to feel some pain, which occurs against the background of a clear visual enlargement of the joint: this is caused by the accumulation of exudative fluid in the joint capsule.

Initially, the patient notes pain when palpating the joint and a feeling of discomfort.

As the pathological process develops, the severity of symptoms increases:

• the joint becomes less mobile, sometimes movement in the joint becomes impossible at all;
• convulsive muscle contractions appear near the affected joint;
• occasionally you may notice a slight increase in temperature;
• swelling occurs in the area of the affected joint, the skin becomes reddish or pasty.

Sometimes the patient notes the appearance of pulsating pain in the joint, as well as sharp pain during movement. The joint capsule gradually becomes inflamed and partially destroyed, as a result of which excessive exudate secretion is observed, or, conversely, atrophic changes in the joint.

If the disease is not diagnosed and treated in a timely manner, it becomes chronic and the pastosity becomes permanent.

Synovitis of the hip joint in a child

Synovitis of the hip joint in children occurs quite often, but the pathogenesis of this disease in childhood has not yet been studied. Basically, synovitis develops in children from one and a half years to the period of puberty.

The disease is characterized by an acute onset and rapid development. Pain in the joint area is more pronounced in the morning, after the child gets out of bed.

It becomes difficult for the child to move the joint; moreover, he often tries to fix the leg in a gentle position (in a bent or adducted state).

Doctors are inclined to believe that synovitis in a child can occur as a result of colds, injuries, and also with prolonged physical activity.

However, since the pathogenesis of the disease is not yet sufficiently understood, a thorough diagnosis must be carried out before prescribing treatment.

It is essential to treat hip joint disease in a child, as it may subsequently provoke the development of chronic lameness.

Synovitis in children is often called reactive or transient.

Transient synovitis of the hip joint is a rapidly developing inflammatory process in the joint capsule caused by any infectious disease or exposure to a chemical or toxic agent. That is why, in order to achieve a positive result in treatment, it is necessary to first find and eliminate the root cause of the hip joint pathology.

Synovitis of the left hip joint can occur as often as the right one. However, simultaneous damage to both joints is extremely rare.

Reactive synovitis of the hip joint is often observed in the case of an allergic response of the body. Why a strong allergic reaction causes damage to the joint has not yet been fully studied. Perhaps the cause is a weakened joint due to trauma or increased load on the hip area.

Diagnosis of synovitis of the hip joint

Diagnosis of synovitis of the hip joint is usually not a problem, but the most important point - finding out the cause of the pathology - is not always easy. In order to clarify the factors of the disease development, it is often necessary to analyze the synovial fluid, which is extracted from the joint cavity by puncture.

The fluid in the joint should normally be sterile and free of microorganisms. Attention is also paid to the appearance of the puncture, its properties and color.

Biochemical studies usually provide data on the state of the vascular system and the joint membrane. The amount of protein detected indicates the degree of membrane permeability. Permeability disorders contribute to metabolic disorders in the joint membrane and fluid, which provokes an increase in the viscosity of the fluid in the joint.

A comprehensive diagnostic examination usually includes a visual examination of the patient, collection of anamnesis, puncture of synovial contents, and, if necessary, the use of arthroscopy data, arthropneumography, cytological examination and biopsy.

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Treatment of synovitis of the hip joint

Of course, first of all it is necessary to influence the causes that led to the occurrence of the disease: cure infectious diseases, colds or other pathologies.

The joint should be kept at rest and motionless, this can be achieved by applying a pressure bandage or plaster cast.

Next, the doctor determines the prescription of medications. It is necessary to take them, otherwise complications may develop in the form of a purulent infection and destruction of the joint capsule.

What drugs are most often used in the treatment of synovitis:

• Non-steroidal anti-inflammatory drugs - eliminate pain, signs of inflammation. They can be used for oral administration, as well as in the form of injections or ointments. In case of concomitant diseases of the digestive tract, the doctor may prescribe the same drugs in the form of rectal suppositories. Non-steroidal drugs include such drugs as diclofenac, nimesulide, ibuprofen, etc.;
• agents that inhibit proteolytic enzymes - they are usually administered simultaneously with diagnostic puncture of the joint cavity. Such drugs include trasylol or gordox;
• corticosteroids - effectively eliminate the inflammatory process, especially in reactive synovitis. Dexamethasone is most often used in this category;
• microcirculation regulating agents – allow to restore joint tissues damaged by inflammation. Such agents include nicotinic acid or thiatriazolin;
• antibacterial drugs - broad-spectrum agents are used, which are most often introduced into the joint cavity after a diagnostic puncture. This method is used for preventive purposes to prevent joint suppuration, or in the case of diagnosed microbial tissue damage;
• complex vitamin and mineral preparations to strengthen the body's defenses.

In the case of an aggressive course of synovitis, when conventional treatment does not bring the desired result, a surgical intervention called synovectomy can be used. During the operation, the surgeon opens the joint capsule, removes suppuration and particles of necrotic tissue, and then rinses the cavity with an antibiotic solution.

Postoperative treatment includes anti-inflammatory, antimicrobial and hemostatic measures. Physiotherapeutic procedures (UHF, electrophoresis) and exercise therapy are then carried out.

The use of folk methods of treating synovitis is allowed, but only simultaneously with the use of conservative therapy. These methods can help speed up the recovery process, but should not be used instead of the main treatment.

You can use the following recipes:

• elderberry flowers are mixed with birch leaves and willow bark in a ratio of 1:4:5. Pour boiling water over it and leave for one hour. Drink half a glass four times a day before meals;
• chop the bay leaf (5 large leaves) and pour in any unrefined oil (0.2 l), leave for 15 days in the dark. After infusion, rub into the area of the damaged joint;
• 10 g of propolis is poured into 100 g of quality vodka, and infused in the refrigerator for about a week. A piece of natural fabric or gauze is soaked in the resulting tincture and applied to the joint. Wrapped in oilcloth and a warm scarf on top. This compress can be done at night or during the day.

When using folk remedies, do not forget to consult a doctor.

Prevention of synovitis of the hip joint

Prevention of synovitis of the hip joint consists of timely consultation with a doctor in the event of the development of inflammatory processes in the body, injuries and metabolic disorders.

When actively doing sports, you should be careful, learn to fall "correctly" so as not to injure the muscular-articular apparatus. The athlete's diet should be balanced and rational, contain a sufficient amount of protein to maintain the ligamentous-muscular system.

If you still cannot avoid a joint injury, you should contact a traumatologist. This will help provide the necessary assistance to the joint in time and avoid complications.

Prognosis of synovitis of the hip joint

The prognosis of the disease depends entirely on the speed of diagnosis and the timeliness of treatment.

If treatment procedures are started on time and prescribed correctly, in the vast majority of situations, complete recovery is expected, while joint function is preserved.

Treatment usually lasts about a week. After that, the rehabilitation process begins, which includes restoring joint function and preventive measures to prevent complications.

Possible complications that develop in the absence of necessary treatment include:

• irreversible damage to joint tissues, which threatens to reduce the range of motion;
• chronic arthritis;
• inflammation of the ligamentous-muscular apparatus in the periarticular region.

In severe cases, sepsis may develop – a general spread of infection throughout the body through the bloodstream.

However, in most cases, synovitis of the hip joint responds well to modern therapeutic measures, which leads to complete recovery and rehabilitation of patients.

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