Synovitis

Synovitis is an inflammation of the synovial membrane, which is limited by its limits and is characterized by an accumulation of an inflammatory effusion in the cavity lined with this membrane.

As a synovial cavity lined in this inflammatory process, there may be a synovial bag (a small flattened cavity lined with a synovial membrane, delimited from the surrounding tissues by a capsule and filled with synovial fluid), a synovial vagina of the tendon, articular cavities. Often occurs (knee, elbow, ankle, wrist). These processes are characterized by the lesion of one joint, rarely - several at the same time.

ICD Code 10

Here, the following are excluded: chronic crepitating wrist and wrist inflammation (M70.0) current trauma - ligament or tendon injuries in areas of the body of soft tissue disease associated with exercise, overload and pressure (M70.0)

• M65.0 This is the abbreviation of the tendon sheath abscess. If necessary, an additional code (B95-B96) is used to identify the bacterial agent.
• M65.1 Means other infectious (teno) inflammations. M65.2 Calcific tendonitis. At the same time, tendonitis of the shoulder (M75.3) and refined tendinitis (M75-M77) are completely excluded.
• M65.3 Represents a snapping finger. Nodular sinus disease. M65.4 Tenosynovitis of the styloid process of the radius (de Kerven's syndrome)
• M65.8 Other inflammations and tenosynovitis. M65.9 Synovitis and tenosynovitis, unspecified. All these codes show the location of the disease and its types. Synovitis is a serious illness that requires a full trial. Due to the localization code, one can understand the seriousness of the phenomenon and prescribe a quality treatment.

Causes of synovitis

The causes of synovitis may depend on other diseases or directly from a diarrhea injury. Most often, it manifests itself in diseases that are metabolic in nature or associated with autoimmune nature. If it occurs against the background of other diseases of the knee joint, then it is secondary. In this case, it can be defined as a reactive suppuration.

Inflammation of the joint with synovitis is usually not accompanied by infection. Simply put, it is aseptic. If there is infection of the synovial bag with various harmful agents, the liquid changes its composition. In this case, pathogenic microorganisms are actively prevailing in the lesion site, which cause inflammation of a different kind, which leads to complications.

[1], [2], [3]

Synovitis after surgery

Synovitis after the operation "behaves" normally. But it is desirable to monitor the patient's condition. After all, serious complications in the form of arthritis are not ruled out. It is possible to reduce the volume of movements due to irreversible changes in the synovial membrane or articular surfaces. There is also a spreading of the process to neighboring parts of the ligamentous apparatus.

The most serious complication of the infectious form of inflammation is sepsis, which presents a danger to life. Sepsis (the appearance of a pathogen in the blood) with an infectious synovitis may develop in people with a weakened immune system (eg, with HIV infection) or in the event of a prolonged absence of treatment.

In any case, a person for a long time should be under the supervision of a specialist. Because relapses occur quite often and avoid them in many cases is not so simple.

Infectious synovitis

Infectious synovitis is usually provoked by pathogens that cause inflammation of a non-specific type. It can be the following pathogens: staphylo-, strepto- and pneumococci. There is a specific type. These include microbacteria tuberculosis.

Pathogenic microorganisms are able to penetrate into the joint with injuries and wounds (contact path), or be carried with lymph and blood from internal foci of infection (lymphogenous and hematogenous pathways). This mechanism of the disease is often found in people who suffer from arthritis and allergic diseases, as well as hemophilia.

It should be noted immediately that getting rid of this type of disease is not so simple. After all, it occurs against the background of infection in the inflamed area. This process is easier to prevent, in time turning for help to a doctor. It is eliminated medically, but it requires qualitative treatment. After all, repeated forms of the disease are possible.

Tuberculous synovitis

It is a form of the disease. It arises hematogenously in the form of a rash of tubercles on the synovial membrane. Clinically, such primary arthritis, in spite of their duration, proceeds in most cases in good order. In most cases, an effusion with thickening of the capsule is formed. But together they do not lead to a curdled regeneration, do not cause destructive changes in cartilages or bones, and often end in the usual sanatorium-orthopedic treatment by restoration of the function of a joint with complete mobility. In the period of onset and initial development, the primary synovial lesions at the knee joint are very similar in appearance to those observed in primary ostites. As for non-specific reactive changes, they differ from them mainly by their constancy. In this respect, they are closer to the early manifestations of secondary synovitis, characterized by a triad - pain, muscle atrophy and some restriction of function, but with a more pronounced effusion and thickening of the capsule in the absence of contractures and with significant safety of movements.

Allergic Synovitis

Allergic synovitis is a kind of disease of a reactive form. Many patients in the formulation of such a diagnosis come in complete bewilderment. After all, not many understand why they developed inflammation of this type.

This form of pathology develops due to toxic or mechanical effects. A variety of allergic reactions are typical for this type of inflammation.

Without specific morphological changes, this species is distinguished by a lighter, usually cyclic, flow. It is observed more often after infection, during recovery from a usually mild acute infection. The trigger can serve as an angina or the cessation of an acute period in dysentery. This type of inflammation is of particular interest in infectious disease. After all, in its manifestation, it resembles a rare form. To date, there are no exact causes of the onset of the disease.

[4], [5], [6], [7]

Traumatic synovitis

Traumatic synovitis occurs quite often, especially in athletes. In case of acute manifestation of the disease, an increase in the volume of the compound is observed for several hours. For this type of disease is characterized by a change in the form of diarthrosis, the smoothness of its contours, and an increase in temperature. There is a possible pain on palpation. In addition, the articular cavity produces an effusion, which is especially well revealed in the knee joint by balloting the patella. Movement in the connection is limited, painful. Weakness, malaise, a moderate increase in body temperature, acceleration of the ROE are noted.

With a purulent form of the disease, the symptoms are more pronounced than with serous. Characterized by the severe general condition of the patient. The contours of diarthrosis are significantly smoothened, reddening of the skin in the joint area, soreness, restriction of movements, contracture. Often in the diagnosis of the phenomenon of regional lymphadenitis. In some cases, the disease extends to the fibrous membrane of the joint capsule with the development of purulent arthritis and surrounding tissue. The area of diarthrosis is significantly increased, the tissues are pasty, the skin on the joints is sharply hyperemic, glossy. If the bones, cartilage and connective apparatus of the joint are involved in the inflammatory process, panarthritis develops. An untreated malaise can recur. Often recurrent suppuration is accompanied by chronic forms of dropsy. They are characterized by further development of hypotrophy and its fibrosis. A vicious circle is formed, aggravating the phenomenon and development of degenerative-dystrophic processes in diarrhea.

Post-traumatic synovitis

Post-traumatic synovitis occurs most often. This reaction of the body to the destruction of the tissues of diarthrosis or its damage. The synovial membrane in this case forms an effusion into the joint. It can also arise without visible damage outside the connection. This occurs in case of irritation of the shell as a result of movements of the joint body, damage to the cartilage or meniscus.

The diagnosis of the disease is as follows. To determine the exact problem and the cause of the inflammatory process of the synovial membrane, it is necessary to find out whether the patient had a trauma preceded by inflammation or an inflammatory disease. After all, this will make it possible to distinguish rheumatoid arthritis from post-traumatic arthritis.

The acute form of the disease is characterized by an increase in diarrtosis in a volume lasting from several hours to several days. There is a change in shape, swelling of the knee, smoothness of the contours of the injured and a rise in temperature around the joint, painful sensations during palpation. The mobility of the joint is considerably limited, and the slightest movement causes acute pain. In this case, there is general weakness, an increase in body temperature, malaise and a blood test shows an acceleration of the ROE.

Symptoms of synovitis

Symptoms of synovitis depend on the variety of the disease. In acute serous nonspecific form, a change in the shape of the joint is observed, its contours are smoothed out. An increase in body temperature is noted, pain is possible when the joint is felt, and an effusion begins to accumulate in the joint cavity. This phenomenon is especially well seen in the knee diarrhea, as it is manifested by the so-called symptom of patellar balloting. For him, the characteristic is the following: with a straightened leg pressing on the patella leads to its immersion in the joint cavity until it stops in the bone, but after stopping the pressure the patella appears to "float up". It is not impossible to limit and painful movements in the joint, as well as general weakness, malaise.

In acute purulent inflammation, the symptoms of the disease are much more pronounced than in the serous form. For a purulent appearance, the patient's condition is severe. It is expressed in a sharp general weakness, chills, high body temperature, sometimes - in the appearance of delirium. Often determined by the smoothed contours of affected diarrtosis, reddening of the skin above it, soreness and restriction of movements in it. Sometimes his contracture occurs. Purulent inflammation can be accompanied by regional lymphadenitis. If this malaise is not cured, a relapse is not excluded.

For the initial period of chronic serous suppuration is characterized by a mild symptomatology. Patients complain of the rapid fatigue that occurs when walking fatigue. All this can be accompanied by restriction of movements in the affected joint, the appearance of aching pain. Gradually there is an accumulation in the joint cavity of an abundant amount of effusion. This phenomenon leads to the development of hydratrosis (dropsy compound). If edema on a diartose exists for a long period, it is possible that it will not be whipped.

Synovitis of the knee joint

The synovitis of the knee joint can be varied. The causes of this phenomenon are hidden in many ways. Inflammation of the synovial membrane develops against a background of metabolic and autoimmune diseases, for example, arthritis, bursitis, hemophilia. Also, the inflammation of the knee joint is able to "form" without visible external damage as a result of cartilage trauma, a meniscus or a lack of binding fluid in the knee joint.

Synovitis, the symptoms of which usually appear gradually, are protracted. Often, symptoms appear 2-3 days after infection. The fluid accumulated in diarrhea leads to deformation of the joint and restriction of movement. The skin around the knee joint is not inflamed, the temperature is normal. The victim feels pain, not very strong, but, in the main, pulling and prolonged.

With inflammation of the knee diar- throsis, it is very important to establish the correct diagnosis, not only to determine the disorder itself, but also to find out the cause, as a result of which it happened. After all, in case of any mistake, a relapse is possible. For accurate diagnosis, the puncture of the knee joint is performed. The surgeon slowly introduces a special needle into the joint cavity and gently selects a little fluid, which is then sent for analysis. The obtained "raw materials" determine the level of blood cells, the amount of protein and the presence of harmful microorganisms. In most cases, the magnetic resonance method and the method of arthroscopy are used, which allow to determine the appearance of diarthrosis, as well as the state of cartilage and diagnose synovitis.

Synovitis of the hip joint

The synovitis of the hip joint is the inflammation of its synovial membrane with the formation of a so-called effusion. It should be noted that inflammation can develop on several joints. The disorder in this case is called chasing, and occurs much more often.

Nonspecific form often becomes a cause of lameness in children, more often they suffer boys from 3 to 10 years. An ailment may appear after an acute respiratory viral infection or some kind of trauma, but the exact cause-and-effect relationship has not been proven yet. If the cause of the development is the infection from internal foci, then this is evidence of the presence of an infectious suppuration, if through trauma - traumatic. Most often, the disease manifests itself spontaneously and develops quickly enough. Inflammation of the synovial membrane leads to the accumulation of fluid, resulting in a tumor of the compound.

Symptoms of inflammation can resemble the symptoms of tuberculosis. This is manifested in the limitation of the mobility of diarthrosis, spasm in muscles and pain sensations. A feverish condition is observed in rare cases, as does a rise in temperature. X-ray examination can show nothing at the early stages of the disease. The only thing that attracts attention is the enlargement of the joint space.

Gradually, night pains become an indicator that the pathology of the joint has begun an active phase of development. The danger of this disease is that it causes unsharp pain, which can be safely endured for quite a long time, especially as it decreases at rest. Ultimately, patients are treated late for help, and treatment in this case is difficult, because the ailment is not easily eliminated.

Synovitis of the ankle

Synovitis of the ankle in its shape can be aseptic or infectious. Infectious variation develops due to the penetration into the synovial bag of an infectious agent of any type. The main causes of the aseptic type include: trauma, hormonal disorders, allergic conditions, neurogenic factors,

Inflammation of the ankle, accompanied by increased pain during palpation in the joint projection. If the pathological process in the affected area begins to develop, swelling and effusion immediately appears, and as a result, hyperemia is observed. Patients mainly complain of a violation of the joint functions, they have an increase in body temperature, the volume of movements is limited.

It should be emphasized that the synovitis of this type, as a rule, develops only in one diarthrosis and does not spread simultaneously to several. Bilateral lesion in clinical practice is very rare. But nevertheless, such cases were encountered.

Synovitis of the shoulder joint

The synovitis of the shoulder joint is an inflammatory process that is formed in the synovial membrane of the joint. It is also characterized by the accumulation of liquid. The disease, the symptomatology of which is described in this article, in most cases occurs due to mechanical trauma, infection or arthritis.

Symptoms of the disease. Basically, they depend on the type of disease. During acute traumatic form, the volume of the joint and its shape increase. Also, the affected person can have an increase in body temperature, limited movement of diarthrosis, general weakness. Purulent inflammation often has such symptoms: severe weakness, chills, delirium, high body temperature. In some cases, redness of the skin in the area of the affected joint, restriction of movements is observed. Recurrent decay is characterized by the appearance of chronic dropsy.

To determine the variety of the disease, you should immediately seek medical help if you have any symptoms. In more advanced cases, the ailment is not so easy to cure.

Synovitis of the wrist joint

The synovitis of the wrist joint is not so common. But at the same time it must be diagnosed immediately. The first thing is an MRI. Thanks to it, the structure of the distal ray-fibrous joint, mid-wrinkle, inter-wrist and carpometacarpal joints is evaluated. All these joints are interconnected functionally, and represent a single carpal diarthrosis. Optimal diagnosis of structural changes in the bones that form these joints is achieved when performing magnetic resonance imaging.

Magnetic resonance imaging of the area of the wrist joint is mainly shown to all patients with trauma, pain in diarthrosis, impaired function and restriction of mobility. The results of MRI can provide the doctor with the most complete information about the condition of the bones forming the wrist joint, ligaments, tendons, joint disc and ligaments that make up the trihedral fibrotic cartilage complex, as well as the ulnar nerve.

Magnetic resonance imaging helps to identify suppuration of the wrist and hand joints, as well as to fully assess the condition of the synovium and the presence of pannums in case of suspected arthritis of various etiologies. Mainly, the cause of chronic pain and impaired function in carpal diarthrosis are pararticular ganglion cysts and tenosynovitis of tendons. They arise as a result of chronic stressful stress in people whose activity is associated with small manual labor. When MRI is performed, it is possible to reliably determine the localization, size of the cyst, evaluate its content, connect the cyst with the joint or synovium of the tendon, which is important in the planning of synovitis therapy.

Synovitis Brush

For the synovitis of the brush is characterized by a gradual onset and slow progression. The disorder begins to manifest itself with periodically arising swelling in the joint. As a rule, this is due to the accumulation of hemorrhagic exudate in its cavity. During the load on the affected diarthrosis, because of the infringement of the outgrowths of the synovial membrane, the occurrence of pain is not excluded. Over time, swelling in the joint and arthralgia becomes permanent.

Movement in the joint for a long period remain in full, then gradually there is and is growing stiffness. In special cases, there are periodic "blockade" of diarrtosis, indicating the presence of "articular mouse". A person can not move the brush freely.

The defeat of the synovium of mucous bags has the symptoms of bursitis and is most common in the ankle. Involving the synovial membrane of the tendon sheath leads to the development of serious tendovaginitis and is usually observed in the tendons of the flexor and extensor of the hand. The general condition of patients, as a rule, is not violated. The body temperature is normal.

Reactive synovitis

A reactive synovitis may cause an allergy. Doctors do their best to eliminate the damaged functions of the affected joint. For this, special general restorative therapy is actively used, as well as physiotherapy and physiotherapy. The actions of physicians, mainly aimed not only at eliminating the cause, but also in relieving the symptoms of the disease. After all, mainly the function and pain are manifested.

To remove strong pain, various drugs are used. Sometimes, in order to cope with this serious illness, the patient has to operate the affected joint. It should be noted that surgical intervention remains an extreme measure. It is used only if there is no effect of conservative treatment or a threat to the health of the patient (development of sepsis).

If a person has noticed any signs of the disease. You should immediately seek help from a specialist. Symptoms are as follows: pain, severe mobility limitations, fever, and changes in the form of diarthrosis. The approach to the treatment of patients, as a rule, is complex, it is determined by the causes that provoked this malaise, and by the mechanism of the development of the pathological process.

Acute synovitis

Acute synovitis appears quite often. The disease is characterized by excessive accumulation of fluid in the joint. In children, inflammation often develops due to injuries. Also, the ailment can occur against the background of inflammatory and infectious diseases, such as rheumatism, tuberculosis, syphilis and others.

With genetic predisposition, as well as against the background of existing neuroendocrine disorders, inflammation can develop with any toxic effect on the body. It can even be an ordinary flu. In this case we are talking about, so-called, reactive inflammation.

Acute suppuration often develops when the infection is infectious or traumatic. In case of trauma, there is a violation of the integrity of the joint cavity, as a result of which the inflammatory process develops. Often the cause of such inflammation is the lack of ligament apparatus.

As a rule, one diarrtosis suffers with lesions, but there are cases when the disease spreads to several joints. The most common inflammation of the knee joint, because it is subject to heavy loads and injuries.

A characteristic symptom of the acute form is the pronounced pain of affected diarrtosis. With palpation, pain is greatly increased. For this form of inflammation is characterized by an increase in the joint in the volume for several hours or days. In his cavity an effusion is formed, which can easily be determined by balloting the patella. The shape of the joint is observed, the shape of the joint changes, and the contours of its contours are noted. The movement of diarrtosis is severely limited. The patient may have general symptoms: malaise, weakness, fever, and high rates of ESR.

[8], [9],

Chronic Synovitis

Chronic synovitis is relatively rare. At the initial stage, clinical manifestations are poorly expressed. Patients complain of rapid fatigue, fatigue when walking. It is not ruled out that there is a slight restriction of movements in the joint and the presence of aching pains. In the articular cavity, the effusion begins to accumulate abundantly, as a result of which hydrocephalus develops. With the prolonged existence of which there is a stretching of the ligaments of the joint. This process leads to its looseness, subluxation and even dislocation. In many cases, mixed types are observed: chronic serous-fibrinoid, chronic viral and viral haemorrhagic.

With chronic serous-fibrinoid stagnation or serous fibrous suppuration, there is a lot of fibrin in abundant efflorescence, which fell out as separate strands and clots. They are actively condensed and thus form free intraarticular bodies.

For chronic villous synovitis, the presence of hypertrophied and sclerotized villi is characteristic. They are able to loosen up with the formation of so-called rice bodies and chondromic bodies. In the chronic form of synovitis, the increase in pathological changes and clinical manifestations of the disease is caused not so much by the duration of the inflammatory process as by the violation of blood and lymph circulation in the diarrtosis capsule as a result of its fibrous degeneration.

[10], [11], [12], [13]

The minimal synovitis

Minimal synovitis is characterized by intense unpleasant sensations and swelling of the affected area. This form is characterized by a change in the joint due to the accumulation of serous fluid in its cavity. The mobility of the organ is significantly reduced, the ligamentous apparatus is weakened, and the cartilage is unstable. If on the basis of the examination the minimal synovitis was diagnosed, then it is sufficient to use a pressure bandage or a special patella.

In the infectious nature of the disease, local symptoms of inflammation are observed. This increase in the size of affected tissues and increase in local body temperature. In acute form, serous fluid accumulates. If you do not start treatment for a long time, purulent corpuscles may appear in it. In this case, the ends of bones will be involved in the process. Over time, there will be signs of general intoxication: high fever, chills, pain, weakness.

Connective tissue in the purulent nature of the inflammation is significantly wrinkled, and the scars form on it. In the future, as a result of changes, there is a violation of the mobility of the connection. In children aged 3-8 years, transient rotting of femoral diarrtosis is usually diagnosed. This inflammation of the cartilage passes quickly, but occurs due to a viral infection, being the most common cause of obvious lameness in children of this age.

Moderate synovitis

Moderate synovitis often accompanies OA, especially in later stages and may contribute to increased pain. In favor of this mechanism is evidence of a reduction in pain with OA in response to treatment with NSAIDs

Pain, which was caused by inflammation, has long been the subject of serious attention, and now the mechanisms of pain associated with inflammation are being actively studied. The fact is that any peripheral pain is associated with an increase in the sensitivity of specialized neurons - nociceptors. They are capable of creating a signal that is recognizable as pain. Increasing the sensitivity of the primary nociceptor in the affected peripheral tissue can lead to an increase in the activity of neurons that send a signal to the spinal cord and the central nervous system, but it must be emphasized that spontaneous electrical activity that causes a persistent pain syndrome can be generated in the inflammatory focus.

A powerful inductor of pain sensitivity are the following pro-inflammatory components: bradykinins, histamine, neurokinins, complement, nitric oxide, which are usually found in the inflammatory focus. Particular attention is paid to prostaglandins, the accumulation of which correlates with the intensity of inflammation and hyperalgesia.

Violation of biomechanics in the affected joint can lead to the development of secondary periarticular syndromes - bursitis, tenosynovitis, etc. When collecting anamnesis and examining a patient with OA, it is necessary to determine what causes the pain - directly by the involvement of the compound or by inflammation localized in joint bags and synovial vaginas. Based on this, it is decided how to eliminate the synovitis.

Pronounced synovitis

Expressed synovitis manifests itself with sharper symptoms. A person suffering from this kind of inflammation is concerned about the severity and pain in the field of diarthrosis. With a minor lesion, the pain syndrome is weak and appears mainly during movements. In severe form, the patient complains of pain and a feeling of bursting even at rest. Movement is significantly limited. When examined, not a sharp swelling of soft tissues, smoothing out contours and increasing the size of the joint is revealed. There may be a slight redness and an increase in local temperature. When palpation is determined by fluctuation.

To confirm the diagnosis and clarify the cause of inflammation, a puncture of the joint is performed, followed by a cytological and microscopic examination of the synovial fluid. According to the patient's testimony, they are often referred for consultations to various specialists. Basically it is: rheumatologist, phthisiatrist, endocrinologist and allergist. If necessary, appoint additional studies: x-ray of ankle diarrtosis, ultrasound, CT of the joint and MRI of the ankle joint, allergic tests, blood testing for immunoglobulins and C-reactive protein, etc.

Villonodular synovitis

Villonodular synovitis is not a malignant condition. It is characterized by the proliferation of synovia, pigmentation with hemosiderin, the formation of nodular masses, villi, pannus. The disorder is rare, more common at a young age.

Symptomatology. PVS can be suspected in the presence of a chronic disease. In general, the knee joint is inflamed, other connections are extremely rare. Over the years, edema of diarrtosis is gradually increasing, moderate pains are observed (severe pain, usually associated with trauma). There is a defoguration of the joint, in the period of exacerbation - effusion, soreness, local hyperthermia, limitation of mobility. At a roentgenography quite often changes are not found out. In extremely rare cases, degenerative changes with osteoporosis, which resemble surface erosion, are revealed.

At a laboratory examination during an exacerbation of the disease, an increase in ESR is possible. The synovial fluid is xanthochromic with an admixture of blood. The diagnosis of PVS can be made on the basis of synovial sheath biopsy: nodal proliferation, hemosiderosis, infiltration by mononuclear cells are characteristic.

Treatment. Synovectomy is indicated only when the compound is severely affected, since recurrence occurs in 30% of cases. In general, synovitis is eliminated medically.

Suprapatellar synovitis

Suprapatellar synovitis occurs against the background of advanced bursitis. Symptoms begin to manifest themselves, on the first-second days after the injury. This happens in the case when the liquid accumulates in the tissues in sufficient quantity and deforms it. This entails difficulties in making movements. If the time is not taken, the inflammation of the consequences for themselves will not be the most pleasant. Therefore, for a certain symptomatology, it is necessary to diagnose correctly.

For injured people, the signs of the disease are very insidious. This can lead to unpleasant consequences in the form of misdiagnosed diagnosis. Detection is complicated by the fact that the ailment of knee diarrtosis symptoms is similar to similar injuries. When the disease is completely absent as the inflammation of the skin, and the local elevated temperature. However, in order to make sure of the diagnosis definitively, they can perform a joint puncture. In the connection cavity, a needle is inserted to take the liquid and checked for the presence of certain blood cells.

Transit synovitis

Transient synovitis of hip dysarthrosis (TC CD) - a disease that often occurs in children from 2 to 15 years. TC has recently taken an important place among other diseases of the musculoskeletal system, its frequency is 5.2 per 10 thousand of the children's population, so it is very important to start taking drugs from an early age.

The causes of inflammation, unfortunately, are not exactly established. There are conflicting views on the etiology and pathogenesis of TS CS in children, there are no strategic directions for the prevention and therapy of this disease. Most likely, the inflammation of the joint synovial capsule has a toxic-allergic origin. In order to exclude this disease, it is necessary to take special measures for prevention.

The disorder can have an acute, subacute and sometimes gradual onset. The defeat of the joint is also manifested by pain in the groin, knee diarrtosis, along the thigh characteristic lameness, restriction and soreness in movements in the hip joint. In 5% of cases, two CS are affected.

The provoking factor for the development of the TC is often any infection, usually respiratory, which the child was sick for 2-4 weeks before.

Exudative synovitis

Exudative synovitis develops most often with prolonged microtraumatism, in people whose work is associated with prolonged pressure on the elbow: engravers, blacksmiths, miners. The fact that the elbow joint is very reactive - even with a minor injury corresponds to excessive formation of scar tissue and ossifits. Preventing the occurrence of bursitis reduces to a decrease in pressure on the elbow process.

During the development of the pathological process may be accompanied by effusion of serous, hemorrhagic or purulent nature, cellular proliferation, fibrosis, and sometimes - calcification of necrotic tissues. Separately, the disease is extremely rare, it is often combined with damage to other soft-tissue structures. In most cases there is a simultaneous or sequential involvement in the pathological process of tendons that touch inflamed articular bags - tendobursita.

Place of localization is inflammation - superficial. Mostly between the bony protuberances and the skin. Synovitis of this type belongs to the first group, since it is located between the skin and the elbow process.

[14], [15], [16], [17], [18], [19],

Serous synovitis

Serous synovitis is an inflammation of the synovial capsule of the joint. Often occurs due to injury, overfatigue of the animal due to early exploitation, acute rheumatism, brucellosis and other diseases.

Main clinical signs. The inflammatory process is rapidly developing. This leads to a sharp hyperemia and swelling of the synovial membrane. Synovial villi, especially near the articular margin, are sharply hyperemic, swollen. The fibrous membrane of the diarrtosa capsule is significantly impregnated with a serous effusion. In the cavity of the joint begins to accumulate effusion, sometimes turbid, containing small-molecule proteins. In the synovial fluid, the number of leukocytes increases, and the content of erythrocytes also increases significantly. In the subsequent to the effusion, the sloughing endothelial cells of the synovial membrane are mixed.

If the process is significantly delayed, then sweat fibrin is observed. As for infiltration, at first it is significantly limited, then acquires a diffuse character. Paraarticular tissues become edematous.

Stuffed synovitis

The nasal synovitis is a kind of fibrogistic cell proliferation. At the same time, formation of numerous vinyl-holodular structures takes place. All of them have local growth. Women suffer from this inflammation twice as often as men. In 80% of cases the knee joint suffers, others, mainly large ones, are affected less often. Occasionally a multiple process develops. Approximately a quarter of affected patients have numerous cysts in the bone around the patient with diarrhea.

The composition of the cyst is myxoid material or liquid. Sometimes in the affected joint there are small areas of apparently unchanged synovial membrane. The nasal outgrowths of this membrane vary both in size and shape. In addition to these, massive nodules without or similar to naps can take place. There are also erosions of articular cartilage. Under a microscope, the villi are covered with synoviocytes, which contain hemosideric in abundance. The fibers of the villi are densely permeated with an inflammatory infiltrate.

Hemosiderin can occur in the cytoplasm of macrophages and outside cells. In some cases macrophages with a foamy cytoplasm and giant multinucleate cells are found. Lymphocytes are usually few. The shapes of mitosis can be found both in synoviocytes and in cells of the inflammatory infiltrate. A certain part of the villi can be sclerized, and occasional whole foci of fibrosis are formed. Pigmented villous-nodular synovitis should be differentiated from traumatic or rheumatic lesions, hemarthrosis and synovial sarcoma.

Secondary synovitis

Secondary synovitis occurs in patients suffering from osteoarthritis. It is characterized by an effusion of light yellow color, clear, normal viscosity, with a dense mucinous clot. At the same time, the content of protein, glucose and lactic acid in the sweat is normal, and the number of cells does not exceed 5000 in 1 mm3, mononuclear cells predominate over polymorphonuclear leukocytes.

Periodically, there is inflammation. It is characterized by mild swelling, fever, and soreness. All these symptoms persist for 3-4 days, in some cases are delayed by 10-15. In some patients, depending on the nature of the lesion and working conditions, inflammatory changes in the joint (secondary suppuration) can recur every 2-3 months. All this leads to the development of sclerotic changes in the synovium. This process negatively affects the functional state of synovial fluid and cartilage tissue. Over time, there are fibrotic changes in periarticular tissues. At the last stage of the process, individual fragments of coarse osteophytes can come off and remain in the free state in the joint cavity. When you fall into the articular gap, the formation causes severe pain, and the patient is deprived of the opportunity to move.

Positive pain in affected diarrhea relapses secondary suppuration. For this, the state is characterized by the displacement of the limb axis, the restriction of active and passive movement in the joints. This leads to the hypotrophy of the regional muscles, which along with the thickening of the periarticular tissues, the displacement of the patella promotes the deformation of the joint. The most pronounced violations of these parameters of muscle function are characteristic for relapse, at a later stage of the disease.

Purulent synovitis

Purulent synovitis occurs more often after wounds, bruises and other damages of diarthrosis. It can develop during the process transition from paraarticular tissues, tendon sheaths, synovial burs associated with the joint. Metastatic suppurative inflammations are observed in sepsis, postpartum infection, washing, paratyphoid, omphalophlebitis, etc.

The diagnosis is based solely on clinical signs and anamnestic data. The correctness of its formulation in necessary cases is confirmed by puncture of the joint and examination of the punctate. At the initial stage of the lesion, when macroscopic changes in synovia are difficult to establish, a qualitative trial with trichloroacetic acid is used. To do this, pour 3-5 ml of a 5 or 10% solution of this acid into the tube and add 2-3 drops of puncture to it, which, under the action of acid, coagulates and disintegrates into small, rapidly settling to the bottom of the test tube of a clump. The upper part of the solution remains almost transparent in the test tube. The drops of synovia, which were removed from healthy diarthrosis, also coagulate when they are added to the solution, but the loose loose clot does not dissolve into clumps and does not settle to the bottom of the test tube.

Proliferative synovitis

Proliferative synovitis is the most common form of the disease. He is due to serious injuries. The shell begins to produce a large amount of effusion. It is cloudy, and contains a lot of protein. The pathological fluid, most often, accumulates in the region of the hip joint. Synovitis, as a rule, is accompanied by increased pressure in the joint cavity. All this indicates that it is necessary to begin treatment as early as possible in order to prevent the violation of motor function in humans.

There are only 4 degrees of the proliferative process: a thickening of the synovia without significant villous proliferation, the emergence of focal villi on the background of thickened synovia, the villi cover most of the synovium of the lateral parts of the joint, leaving the upper section, diffuse villous proliferation, that covers all the departments of diarthrosis.

With inflammation of the secondary-type knee, patients with osteoarthritis observe a light-yellow effusion, normal viscosity, transparent, with a dense mucinous clot.

Recurrent synovitis

Recurrent synovitis occurs with poorly cured acute form of the disease. It is accompanied by chronic forms of dropsy. At the same time, due to constant pressure on the synovial membrane, its hypotrophy and fibrosis develops. All this leads to a violation of the outflow and absorption capacity. There is a vicious circle, aggravating the course of suppuration and development of degenerative-dystrophic changes in the joint occurs.

As the inflammation progresses, the size of the pathological focus increases. With active treatment, this leads to a change in the ratio between the amount of drug administered into the compound and the mass of the affected tissue. On the other hand, this significantly worsens circulation of the fluid in diarrhea and makes it more difficult for the drug to enter the inflammation zone. Eliminate this type of defeat is not so simple. Because if it has arisen once, then subsequent cases of re-inflammation are not ruled out.

Nodular synovitis

Nodular synovitis is mainly expressed in a tumor-like intraarticular node with a diameter of 1-8 cm, varying in shape and color. Men suffer from inflammation twice as often as women. As for the node, it consists of a large number of fibroblasts. Myofibroblasts, primitive mesenchymal cells and histiocytes, some of which contain hemosilerin or have a foamy cytoplasm.

The number of lymphocytes can range from insignificant to huge. Giant multi-nuclear cells can be found. In addition, there are fields collagenized »in places hyalineized fibrous tissue, in which foci of necrosis sometimes occur.

Localized nodular synovitis should be distinguished from synovial sarcoma. In the synovium, rare diseases such as synovial chondromatosis, synovial chondrosarcoma and intraarticular synovial sarcoma can also develop.

Willez synovitis

Ville synovitis is classified as a slowly progressive disease. The nasal and nodal growths gradually appear in the region of the synovial membranes of the joints and tendon shells at a young age. In general, large diarthrosis is affected, especially the knee. In addition to synovial membranes, the process can spread to neighboring tissues, including the adjacent bone.

According to histological data, PVNS is capable of manifesting itself in two types of cells: polyhedral mononuclears and giant multinucleated cells. Intracellular and extracellular deposits of hemosiderin and lipids are found in the lesion focus.

In some cases, there are fields of lymphocytic infiltration. Monocular cells have the form of histiocytes. To date, there is no specific data on the origin of the disease.

Hypertrophic synovitis

Hypertrophic synovitis is a chronic disease. This diagnosis is made according to the morphological study of the synovial membrane. As a result of prolonged irritation of the synovium, pronounced growth (hypertrophy) of its villi is noted. This leads to numerous unpleasant symptoms.

In severe hypertrophic inflammation, when the thickness of the synovia reaches 1 cm or more, the application of this method to chemical synovectomy significantly facilitates the tolerance of the course, and the use as preoperative preparation greatly facilitates the performance of the surgical procedure shown in some cases. The treatment was carried out according to the following protocol: the drug was injected into the cavity of diarrtosis twice a week in the amount of 5 ml of glucose solution into small joints (ulnar, humerus, ankle) and 10 ml into the knee joint. It is important to start treatment on time, or rather to maintain affected diarrhea. Synovitis in this form gives a lot of inconvenience to a person.

Synovitis in the child

Synovitis in a child is extremely rarely characterized by severe pain in the hip joint during movement, which causes parents to understand the anxiety and anxiety quite understandable. True, this malaise goes by itself, usually within a week, without any serious consequences. Preliminary it is necessary to exclude other possible causes of pain in the joint. In many cases, the exact cause of transient inflammation of the hip joint remains unknown. Presumably, the disorder is the result of activation of the immune system due to infection. There is an opinion that this is not a true articular infection, but joint inflammation. The cause of which is the infection of the upper respiratory tract. At a time when the immune system responds to infection. Whether it's the flu or inflammation of the airways, the child has pain caused by a temporary inflammation of the diarrhea. This is a typical reaction of the immune system to viral infections. It is not possible to prevent it even with the help of vaccination.

The true transient synovitis, as a rule, does not lead to any serious complications. Basically, this is a short-term state ,. It usually lasts no more than a week. Ultrasound or magnetic resonance imaging can reveal excess fluid in the hip joint, the so-called effusion. It is extremely important to confirm the diagnosis as soon as possible by examination. With inflammation of lameness, pain and discomfort usually pass about a week later. Most of them last from three to four days, but the duration of symptoms up to seven days should not worry a person. If the symptoms persist for longer than a week, an additional examination is necessary.

What is the danger of synovitis?

Do you know how dangerous the synovitis is? It is definitely difficult to answer this question. Because much depends on the location of the disease. So, the suppuration of the knee joint is dangerous because of its location. The fact is that when moving a person takes all the load on the knee.

In the event of an injury of any kind, inflammation may occur. It is simple to detect that the knee joint is inflamed. The first symptomatology manifests itself on the second day. Initially, there is a pain syndrome. He is not sharp at all, but looks like a aching and protracted. When diagnosing the main thing is not to make a mistake and not confuse it with another disorder.

Unpleasant sensations can be accompanied by an increased body temperature and redness in the area of inflammation. The diagnosis is made exclusively by the attending physician. In general, the ailment is not dangerous if it is immediately treated. Therefore, the main danger lies in the neglect of the disease. If you diagnose it and start fixing it in time, there will be no problems.

Diagnosis of synovitis

Diagnosis of synovitis involves a certain algorithm.

The first thing is an inspection. The specialist reveals a change in the size of the joint, its deformation, redness of the skin, fever, soreness in palpation and movement, as well as the limitation of the motility of diarthrosis and other changes.

Then, laboratory tests are carried out. With intensively developing infectious processes, it is possible to detect inflammatory changes, in general, and biochemical blood tests. With allergic manifestations, it is easy to detect an increase in eosinophils in the blood, immunological shifts (an increase in immunoglobulins of class E). If the process has developed against rheumatoid arthritis, then the relevant biochemical markers are determined.

X-ray method is included in a number of diagnostic measures to identify the disease. Computer and magnetic resonance imaging, ultrasound, reveal the expansion of the joint cavity, in some cases it can be found.

The puncture connection is the last step in the diagnosis. Moreover, this is the main diagnostic method for detecting inflammation. Depending on the fluid obtained, it is possible to determine the nature of the exudate, identify an infectious agent and determine its sensitivity to antibacterial drugs. In many cases, puncture is also used for therapeutic purposes. With puncture, you can simultaneously perform arthroscopy. As additional research methods use arthrography, arthropneumography, biopsy.

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Symptoms of synovitis

Symptoms of synovitis completely depend on the site of inflammation localization. So, first of all diarrhea itself suffers. There, inflammation and damage to healthy tissue can occur. Moreover, the formation of effusion is not excluded. It usually contains a lot of protein.

In general, it is difficult to say unambiguously about echoes. After all, as mentioned above, they completely depend on the site of inflammation localization and its predecessor. Because the damage can develop against the background of the existing disease and become a sign of complication. In other cases, the problem arises from serious injury, especially among athletes.

To carry out diagnostics and to look through those or other changes can exclusively the attending physician. Based on the data obtained, all "deformations" are noted and a correct diagnosis is made.

Treatment of synovitis

Treatment of synovitis in patients should take place at an integrated level. First, the disturbed anatomical relationships are eliminated and then the metabolic shifts in the joint are corrected. With regard to the issue of conservative or surgical treatment, in each individual case it is necessary to decide individually depending on the severity of the lesion, the nature of the secondary intraarticular changes and other causes. If the indications for the operation have been confirmed, then it is necessary to proceed to the consideration of the first stage of elimination of inflammation. Naturally, a full course of drug correction of metabolic disorders of the internal environment of the joint, as well as effective restorative treatment.

Primary indications include early joint puncture with evacuation of synovia and immobilization of the joint with a pressure bandage or patella. In some cases, stiffer stabilization of the joint with tires for rest for 5-7 days is required with the use of days of hypothermia (cold) for the first time. As for prolonged immobilization, it is undesirable without indications, since complications can arise.

Prevention of synovitis

Prevention of synovitis is the timely treatment of inflammatory diseases, which can cause it.

Care should be taken during sports training, to avoid falls and traumatization, to eat rationally to strengthen the ligament apparatus.

When you receive any herbs, you must immediately go to the hospital. The fact is that inflammation in neglected form easily leads to the development of this disease. This must be understood.

In most cases, it all depends on the people themselves. If a person does not monitor his health and does not eliminate the consequences of injuries, then the disease can easily overtake. Moreover, not all people pay attention to the first signs of the disease. This only aggravates the situation and leads to a chronic form. Therefore, with the slightest injury, you must immediately contact a medical center.

Synovitis prognosis

The prognosis of synovitis completely depends on the variety of the disease. In acute forms, in case of correct and timely treatment, the symptoms of the disease are completely reversible.

If the synovitis is recurrent or chronic, then with prolonged existence of hydrarthrosis, ligaments of the joint are stretched, it becomes loose. All these changes can lead to subluxation or even dislocation. Due to the destruction of the integumentary cartilage, it is possible to develop deforming arthrosis, contracture of the joint.

Heavy infectious forms threaten human life. They require urgent medical treatment and treatment. As a result of purulent parasynovitis and panarthritis, later the wrinkling and scarring of surrounding tissues, which disrupt the function of the joint, develops. It is not excluded and relapses of the process and contractures of diarrtosis are possible even after surgical intervention. In general, in most cases the outlook is favorable. But in order for this to happen, it is necessary to begin treatment on time.