Tenosynovit: what is it? inflammation of the tendon of the knee, ankle

Tenosynovitis of the joint (ankle, knee): symptoms and treatment

Tenosynovitis is an inflammation of the synovial membrane of the joint surrounding the tendon. The disease can occur in both acute and chronic forms.

Tenosynovitis develops under the influence of such factors:

1. Injuries. If the joint was damaged, and while a person in the body has an infection, the risk that he will develop tenosynovitis is very high. Treatment will be more difficult and time-consuming if the vaginal bag of the joint has been ruptured, in whole or in part.
2. Failure in the immune system.
3. Rheumatoid arthritis.
4. Dystrophic degenerative joint changes. In neglected form, the changes also spread to the nearby tendons.
5. Infection with certain bacteria and viruses.
6. Age changes when the joint tissues wear out and get insufficient nutrition.
7. Constant loads. Tenosynovitis of the knee or ankle can develop even in those people who are inactive, but at the same time, due to their professional activities or habits, one and the same joint.

Symptoms of tenosynovitis are observed in people of any age, but more often this disease affects the elderly.

Classification of tenosynovite

There are such types of this pathology:

• Stenosing tenosynovitis. This form of the disease is often called the tenodovaginitis of the elbow, ankle, knee or hip joint. The most common inflammation of those tendons that are responsible for the removal of the thumb of the limb to the side. In parallel, a short extensor of the finger can be affected. As a consequence, the mobility of the thumb is severely limited. If treatment in acute form has not been carried out, the disease becomes chronic. Scars and ligaments form scars, eventually a complete blockage of the joint occurs. This kind of tenosynovitis affects mostly women;
• Tuberculosis tenosynovitis. This form of pathology develops if a tubercle bacillus is introduced into the patient's body. Vaginal cavities of the tendons of the hands are affected. The limb is swollen, but there is no pain syndrome;
• Chronic tenosynovitis is inflammatory. The clinical picture with this form of the disease is very similar to that of tuberculous tenosynovitis. Against this background, rheumatoid arthritis often develops. An accurate diagnosis can be made only on the results of studies of effusion from the joint cavity - they will show which bacterium has caused inflammation.

Symptoms of the disease

The pathology develops slowly, at the initial stage the symptoms are very poorly expressed. Therefore, with the first complaints the patient turns to the doctor already with severe tendon lesions, when a long, complex treatment is required.

In a detailed interview, the patient recalls when he first experienced discomfort in the area of ​​the elbow, ankle or the knee joint - if the treatment was started during this period, it would be less prolonged, and the prognosis favorable. In the advanced stage the joint is blocked, it is impossible to restore its functionality to the full.

Recognize the disease can be on such grounds:

1. Increase and edema of the joints during palpation.
2. Limitation of mobility.
3. Severe reddening of the skin in the area of ​​the affected tendon.
4. Pain arising from muscle strain, located next to the inflamed sinew.

Defeat of the ankle

Outwardly, with an ankle joint disease, the tendon does not differ from a healthy one. But the tissues around him are filled with liquid.

The lesions of this part of the lower limb develop against the background of rheumatoid arthritis or after mechanical damage to the limb. Very rarely the cause of an ankle tenosynovitis becomes flat feet.

The pain can occur in any part of the foot, but can cover the whole of it. Unpleasant sensations increase after a long stay on your feet or long walks.

Knee joint injury

The main symptom of knee tenosynovitis is an increase in the patella. Swelling and edema of the knee joint are explained by the accumulation of fluid in the synovial bag, the amount of it sharply increases with the load and movements of the knee joint.

This fluid is the cause of inflammation. The patient usually does not complain of a sharp pain - a strong pain syndrome worries only with exacerbation of the knee tenosynovitis.

The defeat of the long head of the biceps

From this form of illness swimmers, tennis players, that is, sportsmen, engaged in those kinds of sports, in which hand movements over the head are repeatedly performed, suffer.

The cause of inflammation is the constant tension of the biceps muscle, its focus is in the anterior-brachial upper limb. If the treatment is not carried out in a timely manner, the inflammation passes to the elbow joint.

De Cervan's disease

The causes of inflammation in this case are large loads on the tendon of the thumb and wrist.

De Kerven's syndrome usually develops in people who have been performing monotonous movements for many years - typewriters, musicians, cutters, and seamstresses.

Often it is diagnosed in hardworking housewives and summer residents.

If the cause is injury during homework, the disease develops very quickly and the patient does not delay the visit to the doctor.

In the chronic course of de Kerven's disease, examination and diagnosis are usually carried out in the late stages, when the joint is almost completely blocked. Therefore, treatment is also not always successful.

The pains are localized in the area of ​​the thumb, wrist and at the edge of the wrist joint. Sometimes the painful syndrome covers the elbow joint or the entire entire limb.

How is the treatment performed?

Treatment of inflammation of the tendon of the knee, ankle or hip joint is selected depending on its shape and localization. For example, puncture (the most radical method of treatment for this disease) is most often required for knee joint lesions.

When medicines and physiotherapy are powerless, fluid from the joint cavity is pumped out, then a medicine is injected into the cavity.

Sometimes this antiseptic solution, in severe cases, hormonal drugs are administered.

Such methods allow to stop the inflammatory process and start the measures to restore the functions of the joint.

But if the patient on time paid attention to suspicious pain and swelling in the area of ​​wrist, shoulder or knee joints, treatment can be limited to a course of certain medications and physiotherapeutic procedures.

• Medicines should act in three directions: to remove puffiness, to remove pain syndrome and inflammatory process. Usually, preparations of local and systemic action are selected.
• Physiotherapeutic procedures are aimed at activating the metabolic processes in the affected joint, while the effect of medications is enhanced. Electrophoresis, magnetic and laser therapy, ultraviolet irradiation, ultrasound are used. In some cases, a course of therapeutic massage is prescribed.

It is important to choose the right methods and, if necessary, adjust the therapy program to achieve success. Ignoring the doctor's recommendations and self-medication can lead to the most sad complication of tenosynovitis - a complete blockade of the affected joint.

A source: http://sustav.info/bolezni/synovitis/tenosinovit.html

Tenosynovit

What is this - tenosynovitis?

There are two concepts: tendovaginitis and tenosynovitis. Sometimes they are not distinguished, since it is an inflammation of the synovial membrane of the tendons, which consists of connective tissues.

Why are there two names for the same disease? Because it is an inflammation of various layers of the synovial membrane. Tendovaginitis is an inflammation of the synovial membrane of the tendon from the inside.

What is tenosynovitis? It is an inflammation of the paratendon, that is, the synovial membrane of the tendon from the outside.

Tenosynovitis has these types:

1. In form it happens:
2. For developmental reasons:
   • Aseptic - neurological disorders, injuries, allergies, endocrine disorders. It is divided into the following types:

• Traumatic;
• Diabetic;
• Allergic;
• Immunodeficiency;
• Endocrine, etc.

1. • Infectious - proceeds in a purulent form. There are types:

• Bacterial;
• Viral;
• Fungal;
• Specific;
• Nonspecific.

1. Common types of tendon inflammation:

• Stenosing - defeat of a certain joint:
  • Thumb extensor.
  • The long head of the biceps (biceps);
  • Ankle;
  • Knee;
  • The ulnar;
  • Brushes;
  • Hip;
  • The wrist-wrist (tenosynovitis de Cervena).
• Tuberculosis - refers to a group of specific tenosynovitis that develop against the background of tuberculosis.
• Inflammatory chronic - develops as a result of rheumatic diseases.
• Minimum;
• Moderate;
• Expressed.

What are the causes of tenosynovitis of the synovial membrane of the tendon?

What are the main causes and factors of development of tenosynovitis of the synovial membrane of the tendon?

1. Injuries and injuries of the tendon. If it flows without infecting the inside of the injury, then the wound grows faster and the disease easily passes. If the infection gets inside, then it tightens the healing process, requiring medication. For a time a person loses the ability to completely move, as before, a sick limb. But if you recover, then the functionality will return.
2. Rheumatic diseases.
3. Low immunity, which could not overcome the infection, penetrated into the synovial membrane.
4. Degeneration of joints. Disease, like bursitis, often affects tendons.
5. Genetic predisposition.
6. Other infectious diseases, for example, tuberculosis, HIV, syphilis, herpes, etc. Here the infection spreads through the body through the blood.
7. The elderly age, which is marked by the fact that nutrition of the joints with age becomes worse.
8. Load and fatigue of the tendon. Usually in professional activity a person must perform the same actions, that is, load a specific group of muscles, while the others are not sufficiently involved. The lack of diversity in the movements gives a big load, which develops tenosynovitis. This concerns not only actively leading people's lives, but also those who have a sedentary job.

Common symptoms and signs of tenosynovitis develop gradually. It all starts with a slight discomfort in a particular joint.

Adult people usually do not pay attention to this, because they believe that this is temporary. And indeed: acute tenosynovitis will soon pass into the chronic, which is just a matter of time.

Therefore, at the first similar signs, contact a rheumatologist for help:

• The pain is acute, dull, aching, protracted or any other.
• Swelling that can be seen and felt.
• Some immobility of the joint, there is no way to move freely.
• Redness in the area of ​​the affected tendon.
• Pain is aggravated by movement.

Consider the symptoms of the place of inflammation:

1. Ankle joint:
   • Fluid accumulation;
   • Pain throughout or in only one part of the foot;
   • Pain increases with prolonged walking or standing, as with arthritis;
   • Forced change in gait.
2. Knee-joint:

• Swelling of the knee, increases in size;
• Blunt pain;
• Impossibility to move the affected knee;
• Sharp pain during exacerbation.
• Pain in the bicep, which can go to the shoulder girdle.
• Pain near the edge of the thumb or arm wrist;
• Pain can spread to the elbow or to the shoulder;
• The pain is aching in nature, becoming acute in movement.

Tenosynovitis in a child

Is it possible to develop tenosynovitis in a child? Perhaps, but often because of a penetrating injury, which brought the infection. Other reasons that were considered in this article are more typical of adults.

Tenosynovitis in adults

Tenosynovitis is common in adults. Infectious species manifest themselves at any age, as traumatic or allergic. However, there is a special type of tenosynovitis that develop in men and women in old age due to loss of elasticity, tension and strength.

Diagnostics

Diagnosis of tenosynovitis is carried out by a general examination, a blood test, as well as X-rays that exclude osteomyelitis, bursitis or arthritis.

Treatment

Tenosynovitis is treated in three directions: medicamentous, physiotherapeutic and surgical. Let us consider them in more detail.

Than to treat tenosynovitis? Initially, with the help of medication:

• Anti-inflammatory drugs;
• Antibiotics for the infectious nature of the disease: clindamycin, cefotetam, penicillin;
• Immune drugs to enhance immunity;
• Medications that normalize metabolism;
• Analgesics;
• Nonsteroidal anti-inflammatory drugs;
• Painkillers;
• Colchicine and NSAID with the development of the disease as a result of gout.

How else is tenosynovitis treated?

Thanks to physiotherapy procedures:

• Magnetotherapy;
• Laser therapy;
• Ultrasound;
• Electrophoresis;
• Cold and heat applications;
• Ultraviolet;
• Therapeutic massage of the affected joint.

Surgical treatment includes joint puncture, which otherwise does not recuperate. The doctor removes the fluid that has accumulated in the joint, as well as the exudate of the inflammatory process. It injects hormonal drugs to relieve inflammation.

Everything is accompanied by immobilization of the affected part of the body, so as not to provoke pain. The limb is fixed with gypsum, bandages or tires. Crutches are also used to prevent additional stress on the tendons.

At the stage of recovery, immobilizing bandages are removed in order to prescribe a course of therapeutic physical education, which the patient can perform already at home.

Any folk methods should be agreed with the doctor.

Diet

Should I adhere to a special diet? There are no hard recommendations. You can only strengthen the intake of foods that are rich in vitamins and proteins, which will strengthen the immune system and help to overgrow the tendons.

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Forecast of life

Tenosynovitis gives a favorable prognosis of life in case of timely treatment. Patients recover for a month.

How many live without treatment? Life expectancy does not affect the life expectancy, but it can make a person disabled if he is not treated.

Soon the muscles of the affected area are atrophied, making the limb incompetent (non-functional).

A source: http://vospalenia.ru/tenosinovit.html

Tenosynovitis: causes, manifestations and approaches to therapy

To date, rheumatology has moved far ahead. Critical approaches to diagnostics of many systemic diseases have been formed and determined. Patterns are being created to facilitate the treatment of patients with very severe pathology, which doctors could not cure earlier.

But thus the so-called "small rheumatological" pathology is overlooked. This is not about knee osteoarthritis or polyarthritis.

According to statistical data, more than 70% of patients in the structure of diseases of the musculoskeletal system are referring to such nosologies as bursitis (inflammation of the periarticular bag), tendonitis (inflammation of the tendon), tenosynovitis (disease of the tendon and surrounding structures, for example, synovial vagina), myopathies (muscular injuries), enthesitis and entheosopathies (the areas of attachment of the ligamentous apparatus to the bone structures).

How manifested tenosynovial defeat

In this article, we will talk about tenosynovitis, its varieties, causes and clinic with approaches to therapy. Treatment of pathology requires knowledge of the anatomy and manifestations of the disease and what means are preferred in different ways.

Causes of inflammation of tendon bag

Small rheumatological diseases rarely arise within the framework of a more serious systemic pathology.

However, enthesopathies and entesites are frequent satellites of reactive arthritis, ankylosing spondyloatropathy, psoriatic joint damage, lupus arthritis.

Tenosynovitis occurs more often with microtraumatism or in conditions of performing unusual physical exertion. It is characteristic of the knee, ankle and joints of the upper limb.

De Quervain's disease, manifested by inflammation of the tendon of the muscle, which allocates a large the finger of the hand, and the tendon of the extensor muscle involved in its extension, was formerly called disease laundresses.

Tenosynovitis in this area is caused by traumatization of these extraarticular elements. Today it is more typical for schoolchildren, however strange it may seem.

Using mobile devices and other gadgets with games or social networks requires the work of the thumb of the brush.

Tendons and muscles experience fatigue, overload, which leads to chronic inflammation as a result of microtraumatization of these structures. Therefore, tenosynovitis in this area (de Cervin's disease) is found at school age.

Tenosynovitis of the shoulder region (biceps), the knee joint appears when the load lying down on periarticular structures, exceeds that habitual load and causes microfractures, cracks and injury.

Following the mechanical component, cellular elements are directed to the site of pathology, which by secretion of interleukins and other pro-inflammatory cytokines cause the development of a typical inflammation accompanied by pain, swelling and loss of muscle function and tendons. It is for these reasons that treatment of the pathology of the tendon bag should include careful anesthesia, rest affected area and medicines, the action of which is aimed at the repair of the affected tissues and structures the joint.

Pregnancy is a risk factor for exacerbation of many "silent" for the time being and up to the time of diseases.

Often, tenosynovitis (inflammation of the tendon bag) of the knee joint or inflammation of tendon bags of the ankle is beginning to manifest in the first or second trimester.

Obesity predisposes to the development of pathology of the vagina of the tendon of the knee, ankle joints.

Inflammation of tendons and their bags in the shoulder area

Rotating cuff - frequent localization of various pathological conditions accompanied by pain syndrome, the treatment of which is not always selected adequately due to incorrect diagnosis.

The shoulder area becomes the target for rheumatological and traumatological diseases due to the structural features. The cuff is formed by the subacute and supraspinatus muscles, the tendons of the biceps (biceps), the subscapular and the small round muscles.

This structure is the weak point of the described area. Especially the location of the tendon of the long bicep head.

Inflammation of the elements of the rotator cuff of the shoulder

There arises tenosynovitis of the shoulder area more often when lifting heavy objects. This is especially typical for patients who undertake to paint ceilings or glue tiles on it.

Tendons of the long head of the biceps and other muscle fibers are twitching with hyperextension and traumatism with microfractures. Then the inflammatory cascade is launched. The predisposing factor is age.

There are cases when tendonitis developed in the presence of metabolic disorders - hypothyroidism, diabetic organ damage.

Verify the disease of the shoulder area will allow ultrasound examination.

Cracks, ruptures, inflammatory phenomena and calcium pyrophosphate crystals of the main among tendon fibers (especially in the region of tendinous bundles of the long shoulder biceps head) and the surrounding synovial of bags.

How the Hawkins test is conducted

Treatment of the described diseases involves the topical administration of steroid hormones. In the area of ​​the tendon bag of the long head of the shoulder biceps (mezhbugorkovaya furrow) or in the most painful point during the palpation, "diprospan" is introduced.

Preliminarily it is bred by Novokain or Lidocaine, 0.5 ml of the solution is injected. Instead of "Diprospan other hormonal agents may be used, but this drug has a longer duration of the therapeutic effect.

Therefore, given the tendency of tenosynovitis and tendinitis to relapse, such a decision will be most justified.

Introduction of hormones into the shoulder region

Tendinitis and tenosynovitis of hands and fingers

The forearm and the wrist area are less likely to be affected than the tendon structures of the shoulder region. Here you can find two important pathologies:

1. The "snapping finger" syndrome.
2. De Quervain's disease.

Muscle fibers, which provide flexion of the fingers of the hands, have tendon bundles that are joined by a single vagina. With minor injuries and disproportionate loads, they are degenerated and inflamed.

These processes are localized in the projection of interfaoang joints. This is the manifestation of nodular tenosynovitis. "Nodus" in Latin means knot.

The inflammatory process transforms the tenocytes, the cells of the tendon matrix, into chondrocytes that can accumulate calcium salts. Therefore, damaged fibers acquire a nodular form.

Treatment requires the introduction of hormones into the area of ​​the tendons (with an anesthetic). Means of choice - "Diprospan" and its analogs. Treatment is supplemented by physiotherapeutic effects in the cold period and strengthening of the muscular apparatus of the hands with the help of physiotherapy exercises.

How does de Kerven's disease look like

The pathology of de Kerven (disease of laundresses) arises as a result of stenosing tenosynovitis of a tendon structure common to the abductor and extensor of the big toe.

Contrary to the prevailing opinion that the disease has long been in the past, it is increasingly found in young patients and in puerperas in the first few weeks after childbirth. Tendinitis de Kervena is accompanied by a sharp pain in the field of an anatomical snuffbox.

It is located near the thumb, 2 cm to the bottom of its base. Often, there is a swelling in the de Cervin disease.

In the diagnosis of tenosynovitis of this localization, the specific symptom of Finkelstein helps.

It is considered positive and pathognomonic for de Kerven's pathology if the pain in the projection of the "anatomical snuff-box" is reproduced with the medial retraction of the hand clenched into a fist.

Painful sensations can appear if the thumb is brought closer to the palm of your hand and pressed with your other fingers. Quite often de Kerven's disease signals the instability of ligamentous structures within the hypermobility syndrome.

The positive symptom of Finkelstein

Treatment of the disease is limited to restrictive measures, unloading the brush (it is better if it is an orthosis), anesthesia (non-steroidal anti-inflammatory drugs are used).

Do not forget that as with de Cervin's disease, and with other tenosynovitis, glucocorticoids are mixed with anesthetics.

Such a joint use of drugs allows you to adequately anesthetize the topical administration of medications.

Tendinitis and tenosynovitis of the lower limb region

Tenosynovitis in the knee and ankle joint arises less often than the above described situations. However, treatment sometimes causes difficulties for the doctor. It is especially difficult to choose the means for administration.

Between the knee and ankle joint area there are not so many tendon and synovial structures.

They are located mostly on the anterior surface of the tibia (below the knee joint).

In the ankle region, the development of tenosynovitis of the peroneal muscle is typical. Most often he appears with excess weight.

In the region of the lateral malleolus (immediately near the ankle joint, behind the tibia), the formation of an inflammatory nature is located. It has a "colas" shape. At palpation it is sharply painful.

Painful sensations are reproduced or intensified while walking. Treatment of the condition consists of the use of a hormonal drug in the region of the tibia (lateral ankle). Injection may be accompanied by increased pain.

To prevent this situation, "Triamtsenolon" and "Novocain" are injected behind the tibia. 0.3-0.5 ml is a sufficient amount of the drug.

Tenosynovial defeat of the tendon structure of the peroneal muscle

Tenosynovitis of the tendon

Pain along the Achilles tendon marks the development of tenosynovitis in this area.

This condition can develop against the background of other rheumatological diseases: arthrosis of the knee joint, spondyloarthropathies.

Treatment requires adequate analgesia and the appointment of a hormonal agent for insertion into the area of ​​the tendon structure.

A source: http://bsustavov.ru/bolezni/tenosinovit-prichiny-proyavleniya.html

What is the treatment of the foot with the tendonitis of the tendon?

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• Diagnosis of the ankle
• How to treat tenosynovitis?

When a patient is worried about tenosynovitis the tendon treatment of the foot becomes a necessary action. The patient becomes difficult to move because of the pain caused by inflammation. What does the tendon-sinus tendon of the foot provide for treatment, and how is it carried out?

Tenosynovitis is an inflammation accompanied by a lesion of the synovial vagina of the muscle.Late diagnosis and incorrect therapy of the disease can lead to disability.

This ailment extends to the muscular tendons of the wrists, forearms and feet. This is due to the fact that these muscles have the longest tendons.

Quite often tenosynovitis develops in the knee joint. Also, this disease can cause insufficient muscle treatment during surgery.

Tenosynovitis can be detected when there are symptoms such as:

• swelling of the tendon, painful on palpation;
• limited movement;
• pain localized in the tendon;
• pain during movement of the foot or other affected muscle group and redness of the skin in the affected tendon.

Diagnosis of the ankle

With proper diagnosis, the doctor quickly determines how the joints and periarticular tissues have been altered and what treatment is required for the tendon-sinus tendon of the foot.

In some areas of the foot, palpation may cause pain.

This is due to earlier suffered injuries, strong and persistent physical activity, concomitant articular ailments, abnormalities of the foot structure, its functions or the impact of systemic diseases.

When the patient aching feet, palpation is also painful and obvious swelling - this is evidence of tenosynovitis.

When diagnosing, always check the condition of large veins to identify pathologies or lesions. This is done using the ultrasound method.

To assess the condition of the tendons, the patient's foot is positioned at right angles to the shin, then the doctor begins to withdraw the foot, while the patient must perform her resisting actions.

This allows you to evaluate the contours of the tendon of the long extensor and the presence in these tendons of pain or swelling.

Similar manipulations are performed for the evaluation of the tendon condition of the anterior tibial muscle.

Then the ankle joint is examined using the method of deep palpation.

Painful sensations in the anterior part of the ankle often occur when the anterior talon-peroneal ligament is stretched.

The swelling may indicate the presence of rheumatoid arthritis and osteoarthritis.

The swelling, accompanied by pain, which appeared above the anterior talon-peroneal cavity, indicates a ligament injury. Together with this pathology, tenosynovitis is always accompanied by a strong painful swelling.

After revealing all the symptoms and establishing the causes of tenosynovitis, the doctor under the ankle makes injections of novocaine, hydrocortisone and other necessary preparations.

Having performed palpation, the specialist determines where the soreness arises and where the tendon is compacted. Then the limb of the most convenient and correct position is made.

The patient is advised to temporarily restrain himself from fast movements during treatment. This helps prevent the progress of tenosynovitis.

In some cases, the patient is given a tire or bandage to support the limb. To stop or partially reduce the pain, cold compresses can be used.

Further, the doctor necessarily prescribes therapy, which includes the relief of pain and the reduction or complete elimination of signs of inflammatory processes.

For the treatment of tenosynovitis, non-steroidal anti-inflammatory drugs (ibuprofen, diclofenac and other drugs) are often used.

If such treatment does not have an effect, parenteral inputs of glucocorticosteroids or even a scheduled operation can be prescribed.

When antibiotic treatment does not produce any results, then surgical intervention is required to restore the normal position of the tendon.

The operation is performed by excision of the affected vagina.

After the necessary therapy is prescribed, sessions of therapeutic physical training are mandatory.

This helps to restore the muscles that were atrophied under the influence of the disease.

Further treatment with physiotherapy is carried out, and hyaluronic acid may be prescribed to prevent the development of scars of the synovial vagina.

A source: http://ZdorovyeStopy.ru/raznoe/tenosinovit-suxozhiliya-lechenie-stopy.html

Features of synovitis of the ankle

Back and joint health »Diseases

Inflammation of the synovial membrane with the formation of an effusion in the ankle joint is called synovitis.

The disease is rare and takes the third place after the synovitis of the knee and elbow joint.

The pathological process usually affects one joint, without timely medical assistance causes a violation of the motor activity of the lower limb and requires an operation.

Causes and types of the disease

Synovitis of the ankle arises due to various reasons. The nature of the disease depends on the nature of the effusion in the joint cavity.

Aseptic process is characterized by the absence of pathogenic microflora in the exudate, and the inflammation is caused by the influence of pathogenic stimuli.

The causes of aseptic synovitis include:

• injuries (bruises, sprains, dislocations);
• autoimmune reaction of the organism in case of disruption of immunity (reactive, rheumatic, psoriatic arthritis);
• irritation of the synovial membrane with an altered cartilaginous tissue (arthrosis);
• disruption of the nervous system, changes in normal innervation of the joint (neuropathy, neuritis);
• endocrine pathology, leading to disruption of metabolism and trophism of the tissues of the joint (diabetes mellitus);
• hematological diseases that cause hemorrhages in the joint (hemophilia);
• weakness of the musculoskeletal system of a congenital or acquired nature.

Schematic representation of the synovial membrane and fluid in the joint

Infectious synovitis develops when pathogenic microorganisms penetrate the joint cavity. Bacteria can cause a specific inflammation, in this case, the most common pathogens of tuberculosis and syphilis.

Nonspecific inflammatory process develops under the influence of staphylococci, pneumococci, streptococci. Disease bacteria penetrate into the articulation by contact through skin defects or are entered by means of blood and lymphatic pathways from other parts of the body.

Infectious synovitis of the ankle develops in the following cases:

• abrasions, bruises, cut wounds;
• suppuration with hematoma;
• abscesses, furuncles, phlegmon;
• chronic foci of infection (tonsillitis, cholecystitis, caries);
• generalization of infection in the body (sepsis).

According to the nature of the course, the synovitis is divided into acute and chronic form. In the first case, the pathological process develops in infections and ankle injury.

In the second case, the disease occurs against a background of prolonged exposure to adverse factors, such as arthrosis, reactive arthropathy, disruption of the endocrine and nervous system.

According to the nature of the effusion in the joint, there are:

• serous synovitis - the liquid is transparent with increasing cellular composition and protein content;
• hemorrhagic synovitis - a clear fluid with an admixture of blood;
• purulent synovitis - a cloudy, greenish liquid, has a putrefactive odor;
• Serous-fibrinous synovitis (adhesive) is a small amount of a viscous fluid containing a large amount of fibrin.

The identification of the cause of pathology is of great importance for the designation of an adequate therapy regimen and the prognosis of the disease.

Manifestations of the disease

The most pronounced clinical picture is expressed in the acute form of synovitis of the ankle joint.

Chronic course is characterized by periods of exacerbation and remission (remission) of the inflammatory process.

During the period of remission, the symptoms of the underlying disease come to the fore, which led to the inflammation of the synovial membrane.

Swelling of the ankle due to accumulation of exudate

Clinical manifestations of synovitis:

• pain in the area of ​​the affected joint;
• Painful sensations increase with movement;
• swelling of the soft tissues above the ankle, smoothness of the contours of the joint;
• redness of the skin in the area of ​​inflammation, increased local temperature;
• discomfort when feeling the joint, a sense of fluid motion (fluctuations).

Infectious synovitis often occurs with symptoms of intoxication, which include fever, loss of appetite, headaches, weakness, sweating.

A variant of the disease is tenosynovitis, which is an inflammation of the synovial membranes of the tendons of the muscles involved in the movement of the ankle joint. It develops with systemic diseases, traumas and infectious processes in the foot.

Tenosynovitis clinical manifestations:

• soft tissue swelling in the tendon site;
• soreness with palpation of inflamed tendons;
• redness of the skin in the area of ​​affected tendons;
• formation of a dense strand in the site of inflammation;
• difficulty walking;
• pain of varying intensity during contraction of the affected muscles.

Therapeutic tactics

To diagnose and prescribe the treatment, laboratory and instrumental examination methods are carried out.

In the general analysis of blood, an increase in the number of leukocytes (leukocytosis), shift of the leukocyte formula to the left, high rates of ESR are determined. This pattern of blood is characteristic of the infectious nature of the disease.

In system pathologies, high indices of C-reactive protein, seromucoid, sialic acids are revealed. The study of the synovial fluid determines the nature of the effusion in the joint cavity.

Radiography of the ankle is carried out in a straight and a side projection

After the establishment of the final diagnosis, conservative therapy is performed according to the severity of the course of the disease.

Treatment of synovitis of the ankle includes:

• puncture of articulation for exudate sampling and administration of antibacterial agents or glucocorticoids;
• immobilization of the ankle with a tight bandage or a longus to reduce motor activity and pain;
• non-steroidal anti-inflammatory drugs (NSAIDs) to eliminate inflammation of the synovium, prevention of accumulation of exudate in the joint cavity, reduction of pain syndrome - diclofenac, movalis, nimesulide;
• glucocorticoids with intense pain and high volume of effusion - prednisone, dexamethozone, kenalog, diprospan for intra-articular injection or reception in tablet form;
• inhibitors of proteolytic enzymes in chronic forms of the disease - trasilol, ingiprol, contrikal;
• antibiotics of a broad spectrum of action in infectious synovitis - cefazolin, azithromycin, lincomycin;
• basic means in case of reactive arthropathies - methotrexate, sulfasalazine, plaquenil;
• physiotherapy - electophoresis, UHF, magnetotherapy;
• Therapeutic physical culture during the rehabilitation period of the disease.

In severe cases of the disease and in the ineffectiveness of conservative therapy, surgical intervention is performed on the affected joint.

The ankle joint is opened, the cavity is cleaned of foreign bodies, blood clots or pus, cartilage defects and synovial membrane are removed.

After the operation, the wearing of orthoses is prescribed and therapeutic gymnastics is performed to restore the functional activity of the joint.

Synovitis in the acute phase requires immobilization of the articulation

For the prevention of synovitis using traditional medicine.

1. Oil from laurel leaves. Lava oil has antiseptic and regenerating properties. To make it, take 50 grams of crushed laurel leaves, pour 500 ml of vegetable unrefined oil, insist for a week. The filtered ankle joint is rubbed 3-4 times a day.
2. Ointment from the grass comfrey. Comfrey has analgesic, wound-healing, anti-inflammatory action, improves blood flow and normalizes metabolic processes in the pathology area. Ointment is prepared from 150 grams of chopped comfrey grass and 200 ml of interior fat. The ingredients are thoroughly mixed, placed in a glass container and insisted for 10 days. Ointment is applied to the affected joint thrice a day with a bandage bandage applied.
3. Decoction of herbs. To normalize the synthesis of synovial fluid, strengthen immunity, improve blood supply in the area of ​​inflammation, take a medicinal broth. For its preparation, take licorice, St. John's wort, thyme, marshmallow, calendula, valerian in equal proportions. The ground mixture in an amount of 20 grams is filled with half a liter of water, boiled for 5-7 minutes, filtered through a filter. The resulting broth is taken on several sips between meals.

Prevention of the disease also includes prevention of hypothermia and lower limb injuries, wearing comfortable shoes, a dosed approach to physical exertion.

Synovitis of the ankle has a favorable outcome with timely diagnosis and therapy of the disease.

Otherwise, the pathological process may require surgical intervention and a long period of rehabilitation.

Launched forms of the disease lead to a limitation of the functional activity of the ankle and the development of disability.

A source: http://MoyaSpina.ru/bolezni/osobennosti-sinovita-golenostopnogo-sustava