Synovitis of the ankle

Synovitis is an inflammation of the joint bag, in which a lot of liquid accumulates in its cavity.

All large joints can be affected, but ankle damage is not so common. According to the nature of inflammation, the synovitis can be:

• Serous;
• Serous-fibrinous;
• Hemorrhagic;
• Purulent.

Causes of synovitis of the ankle

The causes of synovitis of the ankle may be different.

By the nature of the cause, the inflammation of the joint bag can be:

• Infectious. It develops with the penetration of microbes into the synovial sac, it is especially common in the wounding and rupture of the joint capsule, as well as with the blood and lymph flow from the affected tissues located side by side. (specific pathogens - streptococcal, staphylococcal, pneumococcal infection, nonspecific - pale treponema, tuberculosis bacillus, etc.).
• Aseptic. Occurs when:
  • traumatization of the joint (fracture, bruise, damage to the ligament apparatus);
  • damage to the articular sac with tearing fracture, ligament damage;
  • endocrine pathologies;
  • problems with metabolism;
  • congenital malformation of blood clotting.
• Allergic. It arises as an allergic reaction to a certain allergen.

The causes of synovitis of the ankle joint are accompanied by serious diseases and injuries, therefore they require urgent treatment to the doctors and special treatment.

[1], [2], [3]

Symptoms of synovitis of the ankle

Symptoms of synovitis of the ankle are as follows:

• Hyperemia and an increase in temperature at the site of the patient's joint, movements are severely limited and accompanied by pain;
• Joint articulation is increased due to accumulated blood, pus, serous effusion;
• With a purulent form of synovitis, the overall body temperature rises.

When the nonspecific acute synovitis joint increases, it is felt bursting, painful when pressed and moving. When probing the joint articulation, there is a fluctuation - a fluctuation of the fluid in the cavity of the joint bag.

In acute purulent inflammation, the clinical manifestation is more pronounced - there is intoxication (temperature jump, feeling of weakness, chills). Articular articulation is edematic, hyperemic, mobility is limited. The adjacent lymph nodes are enlarged, painful.

In chronic serous or hemorrhagic synovitis, a rapid clinical manifestation is not observed. The disease develops slowly, the pain is aching, manifested with a monotonous movement in the joint articulation.

Symptoms of synovitis of the ankle joint indicate very serious concomitant diseases requiring urgent specialist consultation and qualified treatment. Otherwise, serious life-threatening diseases can develop.

Reactive synovitis of the ankle

Reactive synovitis of the ankle - an allergic form of inflammation, develops as a result of contact with the allergen and its ingestion in trauma, a concomitant disease. Inflammation can develop without previous injuries and physical exertion, a small cut or release of toxin in certain diseases. Sometimes the reactive form develops with unstable fixation of the joint, so it is better not to postpone the trip to the doctor to clarify the diagnosis.

The reactive form is quite violent - it disturbs severe pain, movement is restricted, muscle activity decreases, because of the passivity of the limb, the ligamentous apparatus also weakens. At this stage, urgent medical intervention and step-by-step treatment will be required, with the subsequent restoration of the entire volume of articulation and limb functions.

To diagnose and identify the pathogen, puncture the joint cavity and perform a bacteriological analysis of the contents. According to the analysis I prescribe t antibacterial therapy (if necessary).

Often this disease occurs in athletes engaged in football, hockey, as well as runners. For prevention it is better not to miss planned medical examinations, and in case of injuries or pain in the articulation immediately seek medical help from a doctor.

Diagnosis of synovitis of the ankle

Diagnosis of synovitis of the ankle is based on the clinical conclusion, the results of intraarticular puncture. The main task at this stage is not only to confirm the diagnosis, but to identify the causes and pathogen. In acute and chronic form of synovitis, arthroscopy and arthropneumography are performed, in some cases a biopsy of the joint bag is carried out for the purpose of cytological examination of tissues.

If concomitant diseases are suspected (the probability of hemophilia, endocrine disorders, metabolic pathology), then a series of special analyzes is prescribed. If suspected of an allergic etiology, a test is performed on the hidden allergen.

To identify the pathogen, puncture the articular ankle bag. The obtained contents are sent for bacteriological analysis to identify the nature of the pathogens and their sensitivity to bacterial preparations. Also important characteristics of the treatment are effusion characteristics, such as viscosity, percentage of protein compounds, chondroprotein, hyaluronidase, lysozyme, etc. - the presence of these components indicates the destruction of the cartilaginous layer of the articular surface. With a purulent form, not only the purulent contents of the joint bag are examined, but a blood sample from the vein is also taken for bacteriological examination to exclude the possibility of septicemia.

[4], [5], [6], [7], [8]

Treatment of synovitis of the ankle

Treatment of synovitis of the ankle may be conservative and surgical. With synovitis of the clarified etiology, the treatment can be outpatient. If the case of a secondary synovitis is fixed, then an additional consultation of a hematologist, an endocrinologist is prescribed. If the effusion in the joint cavity is serous and rapidly accumulates, then hospitalization is indicated. If the inflammation is a consequence of trauma, then treatment is indicated in the department of traumatology, with acute purulent form - treatment is performed in the surgical department.

In the treatment of an aseptic form of sufficient tight bandaging of the articulation and restriction of motor activity. If necessary, they can prescribe painkillers and anti-inflammatory drugs, therapeutic lavage of the joint. In the rehabilitation period, UHF, electrophoresis and other physiotherapeutic procedures are prescribed. With prolonged flow, electrophoresis is performed using lidase, potassium iodide. Phonophoresis is also shown.

Purulent form requires mandatory immobilization of the limb. With an easy flow, the purulent contents are excreted during puncture, in severe cases, the opening and drainage of the joint cavity with obligatory washing with antibiotics and the appointment of antibiotics and painkillers inside is shown. In the postoperative period, further treatment and rehabilitation are carried out.

In chronic conditions, first treat the underlying pathology, given the severity of the disease, secondary changes in the joint cavity. The course of conservative treatment includes anti-inflammatory drugs, analgesics, glucocorticoids, rumalon, achimotripsin, and in severe cases it is recommended to use contrikal, trachsil. From 3-5 days appoint physiotherapy.

At the stage of rehabilitation, it is also possible to use some alternative methods, but only after a preliminary consultation of the doctor. Infusion of herbs: mistletoe, oregano, St. John's wort, thyme, eucalyptus, bearberry, tansy, valerian, calendula, licorice, althea root, rhizome of calamus, is prepared based on 1 teaspoon of each name for 500 ml of boiling water. Eat like tea an hour or two after eating for 2 months.

Prevention of synovitis of the ankle

Prevention of synovitis of the ankle is carried out in two directions, including proper treatment of foci of inflammation in the body and associated diseases and mandatory warming up before the warm-up, physical activity. Also it is necessary to protect bones and ligaments from traumas during falls, sprains, tearing ligaments, it is necessary to eat correctly to strengthen the skeleton and ligaments. In the diet must be food with the content of gelatin, vitamins C and D, agar-agar, phytoncids.

Prognosis of synovitis of the ankle

The prognosis of synovitis of the ankle with proper treatment is favorable, but if the medical prescriptions and the course of medicines are not observed, the following complications are possible:

• Development of a purulent form of arthritis - if a purulent inflammation has spread to the fibrous layer of the joint bag.
• The deforming form of arthrosis is the defeat of the genal cartilage. It occurs most often and develops over a long term.
• Development of panartritis - when not only cartilage, but also bones, ligaments become inflamed.
• The development of hydratrosis is the accumulation of exudate in the joint cavity.
• Development of Baker's cyst, which is characterized by increased thrombosis, circulatory disorders, numbness of adjacent tissues, convulsions. In the future leads to a violation of trophism, gradual necrosis and loss of the limb.
• Ossification and fusion of the joint. It leads to complete immobility in the joint articulation.
• Repeated cases of synovitis after excision of the joint bag.
• Transition of purulent fusion to adjacent tissues - manifests itself in the form of phlegmon, periarthritis.
• The penetration of infectious agents into the bloodstream and the development of sepsis - the infection of blood, leading to death.

The prognosis of synovitis of the ankle joint with aseptic and allergic forms is favorable - restoration of all functions of the joint occurs in full. In chronic course, stiffness and restriction of movements in the joint are formed. With a purulent form of contracture, the probability of infection of blood and heavy diffuse purulent lesions of adjacent tissues is high.