Synovitis of the knee: what is it? symptoms, treatment

Causes, symptoms of synovitis of the knee joint, methods of diagnosis and treatment

Synovitis of the knee joint - inflammation of the knee joint membrane, in which excess fluid accumulates in the joint cavity (other names effusion, exudate - it can be blood, pus or lymph).

Synovitis significantly complicates the life of the patient: painful sensations make movement difficult, interfere with full rest and sleep. And with complicated infectious inflammation, hospitalization and surgical treatment are indicated.

However, with properly selected and timely treatment, the disease can be cured, the prognosis for healthy health(more about therapy - later in the article).

The origin, flow and treatment of the synovitis of the knee does not differ from the synovitis of the other joint.

The only characteristic difference is that knee involvement is more common: it is due to a large physical load on this joint (relative to other joints), which can cause injuries and damage.

Synovitis is treated by an arthrologist or orthopedic surgeon.

Further in the article you will learn about the causes, symptoms, methods of diagnosis and treatment of pathology.

Causes of synovitis

Most often, the synovial membrane becomes inflamed when an artery is injected into the joint with a current of blood or lymph infection from other organs.

Other causes of synovitis of the knee joint:

• knee injury;
• lesions of ligaments, meniscus, cartilaginous surfaces;
• developing arthritis;
• metabolic disorders;
• endocrine changes in the body;
• increased sensitivity of synovial cells to allergens.

(if the table is not completely visible - turn it to the right)

The four main symptoms

1. swelling of the knee,
2. redness of the skin (hyperemia),
3. pain,
4. restriction in motion.

Symptoms of synovitis of the knee in the aggregate form a syndrome, characteristic for many diseases and knee injuries (arthritis, arthrosis, dislocation and others).

Therefore, before the appointment of treatment, the attending physician should carefully conduct differential diagnosis (differential - that is, establish an accurate diagnosis, excluding other possible diseases).

Diagnosis of the knee synovitis

To choose the right treatment, the doctor, in addition to palpation and examination of the joint, finds out the presence of concomitant diseases. The doctor does this also to determine the nature of the synovitis (primary or secondary).

Instrumental methods that help clarify the diagnosis of synovitis of the knee:

• Puncture. For puncture, a certain amount of effusion (excess fluid) is taken from the joint cavity: if bacteria are present in it - the disease has an infectious cause; when detecting ragocytes (blood cells containing rheumatoid factor) - speak of rheumatoid origin disease.
• The radiograph shows a darkening in the area of ​​the synovial bag.
• Ultrasound and MRI are more informative than X-rays: they also allow you to see the thickened shell of the joint and the accumulation of fluid inside.

Methods of treatment

At the beginning of therapy, the joint should provide complete peace of mind - for this purpose, a tire, a gypsum dressing (longi), and a tight bandage are applied.

At the next stage of treatment, medicines and physiotherapy are used.

LFK and massage with synovitis do not use. The use of curative gymnastics is possible only during the rehabilitation period after surgical treatment of the disease.

Medicines

What results does the medical treatment of synovitis have?

1. eliminates the pain symptom,
2. reduces inflammation and swelling,
3. resolves the effusion,
4. prevents the transition of the inflammatory process to the joint structures.

In the table below, the main drugs used for synovitis of the knee:

(if the table is not completely visible - turn it to the right)

Physiotherapy

Physiotherapy with synovitis eliminates pain, reduces inflammation, normalizes blood and lymph circulation in the synovial membrane of the knee joint, promote resorption of exudate and recovery tissue structures.

The main physiotherapeutic methods that help to cure the synovitis of the knee joint are presented in table below (in order of reduction of the therapeutic effect: from above - the most effective methods, then - more weak).

(if the table is not completely visible - turn it to the right)

Surgery

In the case of ineffectiveness of medication for obtaining more complete information about the pathology, arthroscopy is done - a surgical procedure with minimal interference into the body.

Using an arthroscope, the doctor clarifies the condition of the tissues of the joint bag and clarifies the diagnosis (excluding or confirming other diseases: gouty arthritis, deforming arthrosis and others).

If necessary, a biopsy of the altered tissue of the synovial membrane is performed.

Chronic synovitis of the knee joint with frequent relapses and not passing symptoms, as well as pronounced changes in synovial shells (with tumor-like growths) are indications for a synovectomy (complete or partial removal of the altered tissue). In the postoperative period prescribe antibiotics and analgesics, physiotherapy (from the first day). Fixed joints are provided for a week, but walking is allowed as early as the second day after surgery.

Forecast

With proper treatment and compliance with the prescription of the doctor, the synovitis of the knee joint can be successfully cured.

In advanced cases with infectious synovitis, it is possible to develop contracture (restriction of movements) and even sepsis ("blood poisoning").

Do not allow the development of the disease to the borderline - if you have any suspicious symptoms, immediately consult a doctor.

Take care of your joints and stay healthy!

A source: http://SustavZdorov.ru/koleni/sinovit-kolennogo-sustava-264.html

Treatment of synovitis of the knee joint: symptoms, folk remedies

In the human body, the knee joint is the largest. The responsibility incumbent upon him is also great, since the knee joint is subjected to enormous pressure when moving.

Therefore, if you take the statistics of ailments, it is the diseases of the knee that are frequent cases in traumatology. However, the knee is not only injured. Damage can concern not only the bone structure or ligament apparatus, but can cause dysfunction - synovitis of the knee joint.

In this disease, the formation of serous exudate without particles of blood, in a moderate amount.

MKB 10 synovitis of the knee joint has been considering since 2007, under the code M65.

Causes of synovitis of the knee joint

1. Injury of the knee (meniscus, ligament, fracture). You can get injured anywhere, at home, while playing sports, for example, hitting your knee, unsuccessful landing when jumping.
2. Rheumatic Disease
3. Presence of allergy
4. Syphilis
5. Tuberculosis
6. Gout, diabetes mellitus
7. Age-related changes in joints

Depending on the source of the disease, it can have different types:

• Primary, which is manifested due to the underlying disease.
• Secondary, appears on the basis of a primary ailment or trauma.
• Post-traumatic, accompanied by damage to the knee joint, as well as surgical manipulation.
• Infectious, which becomes the result of the manifestation of the vital activity of microorganisms. Thus it can be as nonspecific, that is caused by streptococci, pneumococci and staphylococcus, the herpes virus, advanced ARVI, sore throat or flu. It can be specific, that is, develop from a tuberculous bacterium.
• Aseptic, not having microbial sources. It may be caused by post-traumatic or allergic synovitis, based on other joint and body diseases. Its nature is based on the destruction of tissues, which entailed mechanical injuries, both of the knee itself and of the joint. Also, the development of aseptic synovitis gives rise to hemophilia, a disruption in the functioning of the endocrine system, and a metabolic disorder.

In the ICD 10, the synovitis of the knee joint is divided:

1. - on serous synovitis
2. - on serous-fibrous synovitis
3. - on hemorrhagic synovitis
4. - on purulent synovitis

The role of fluid in the joints

The knee has a difficult relationship of bones. The basis of the knee is the tibia and femur, the patella.

Inside the joint are two semirings of cartilaginous tissue - a meniscus.

Together with all this joint, the knee is filled with ligaments, providing strength and functionality of the joint.

The knee has a "clutch" - an articular bag, which on the outside has a coarse fiber, and inside - a set of vessels that impose all the connections on the surface. Because of its extensive structure, the shell in the face of cartilage, bones, muscles and ligaments creates a variety of depressions, and wraps the knee

The origins of the disease lie in the formation of fluid in the knee joint. The fibrous capsule secrets the accumulated fluid in the joint, which is covered by a synovial membrane consisting of a layer of cells.

The liquid itself is proteins, minerals and carbohydrates, because it is a nutritious element of the cartilage in the joint, acting as a lubricant or shock absorber of the knee, saving it from all kinds of injuries.

In a normal state, the volume of the liquid is 2 ml, which is maintained by resorption of intraarticular tissues.

The maintenance of equilibrium in it is a delicate process, which can be easily broken, if there is inflammation. Thus, the appearance of synovitis of the knee joint increases the fluid, dramatically changing it from nutrients to bacteria, pus and blood, toxins and the like.

The difference between the infectious and acute forms of synovitis

Aseptic synovitis, characterized by a large volume of the knee, which is not accompanied by any pain or other. When there is no pain, but there is the presence of volume - this is the consequence of the presence of irritation of the shell.

The liquid in the joint bag can increase dramatically in quantity, up to one hour. Puffiness, which subsequently formed, would be a serious obstacle to freedom of movement.

This form of the disease can be accompanied by symptoms:

• total depletion
• there is no temperature
• there is a volume of joint that increases every moment
• Immersion of the joint under pressure on the knee

Moderate synovitis of the knee joint is manifested in a small volume of the knee, while the patient can move freely without feeling pain. The general condition may worsen, but not significantly.

The acute form of synovitis is characterized by sharp pain. If such an indicator exists.You should immediately consult a doctor to determine the source of the disease. Accompanying the acute form:

1. an increase in the joint
2. redness of the knee, while the skin has an unpleasant shade, shiny, stretched
3. high fever throughout the body
4. the patient feels exhaustion, tenderness of muscles
5. sharp pain at the slightest stirring

Chronic synovitis of the knee joint is not accompanied by pronounced symptoms, but has dull pain, together:

• with restriction of movement, fatigue
• crunchy
• dislocation

Reactive synovitis can occur only in an acute form, which gradually flows into a chronic one, in the absence of competent and timely treatment.

Diagnostic measures

The most difficult thing in diagnosing synovitis is the definition of the primary source, diagnose it, knowing the reason is simple.

The program for diagnosis of synovitis of the knee joint is accompanied by:

1. Careful collection of anamnesis data, on the basis of which it is possible to confirm or refute a number of diseases.
2. Professional examination of a specialist - palpation, general examination, under the accompaniment of tests.
3. Carrying out of studies, UAC and urine, investigation of the synovial fluid.
4. Conduction of CT, MRI, ultrasound of the knee joint, radiography.
5. Puncture and biopsy - in severe cases.

The diagnosis is a synovitis of the knee joint, with competent treatment, in principle, we will win.

However, you need to know that full recovery can only be with serous and allergic synovitis.

After the transfer of other varieties of synovitis, as a rule, stiffness of joints remains, with purulent formations, unfortunately, sepsis develops.

The complexity and danger of synovitis is precisely in the mortality of the outcome of the disease, and not in the preservation of mobility and the aesthetics of the knee joints.

Therefore, one should not ask the question - how to treat the synovitis of the knee joint alone, relying only on grandmother's recipes and homeopathy.

This is a serious undertaking and requires an appropriate approach.

Treatment of synovitis of the knee joint

The diagnosis of "synovitis of the knee joint" is treated in an outpatient setting. If the disease occurs in an acute form, it is necessary to tightly knead the knee in an even state due to a tight bandage.

A bandage worn for more than 7 days is not recommended, as this will lead to joint tightness, which means - lack of mobility. Until the help is given, the knee should be wrapped in "cold" for 10 minutes.

Treatment of synovitis is carried out in such directions:

• elimination of the source itself
• elimination of malfunctions
• symptomatic therapy
• general restorative therapy
• physiotherapy
• Exercise therapy

Physiotherapeutic procedures are conducted in the form of:

1. Carbonic baths
2. Baths with hydrogen sulphide
3. Radon and oxygen baths
4. Current at low frequency
5. Ultrasound
6. Paraffinotherapy
7. Mud treatment
8. Infrared, ultraviolet and infrared radiation

tablets from pressure

Medical treatment of synovitis of the knee joint is carried out by using:

• nonsteroidal anti-inflammatory drugs
• glucosteroid agents
• chondroprotectors
• inhibitors of proteolytic enzymes

If in the human body, there are pathogenic microbes and bacteria, tetracyclines, cephalosporins and macrolides, sulfonamides, are appointed, depending on the source.

Circulation of blood is improved by intramuscular injection of heparin. To treat the wound - antiseptics, as well as rubbing and applying ointments - fastum, voltaren, indovazin.

It is important to understand that synovitis may be poorly administered to drug treatment, and also to have complications. In this case, surgery can be prescribed, in which partial or complete synovectomy is performed.

Carrying out a puncture is a necessary measure, which is performed without anesthesia, by piercing with a needle, a joint, and then the accumulated liquid is aspirated. Exudate can be sent to a laboratory study to obtain more accurate information.

As an auxiliary therapy, and only after conducting a professional examination and correctly prescribed treatment, it is possible to apply recipes from traditional medicine.

Folk methods of treatment of synovitis of the knee joint

Treatment of synovitis of the knee joint folk remedies involves the use of compresses from eggs, comfrey ointment, bay oil, various infusions.

In particular, laurel oil has proved its worth. For its preparation, grind 2 tbsp. spoon bay leaf, cover the mixture of 200 gr. oil.

The resulting composition is applied to the skin twice a day, fixing it with an elastic bandage.

For eggs, compress 1 egg and salt. Blend the mixture on a knee, wrap it with an unsterile bandage, soak for 30 minutes.

You can prepare omega-coma ointment, from 200 g. Pork fat and a glass of fresh grass comfrey. Mix the mixture and insist 5 days in a cold place.

Ready ointment applied to the knee several times a day, fixing an elastic bandage.

This can perfectly help to restore cartilaginous tissue after surgery.

To prepare the infusion, you need to grind the lemon kg. garlic, kg. celery root, mix everything in a container and pour three liters of water, leaving for 3 hours. Infusion is drunk three times a day for 60 ml. for 30 days.

Among the recipes of folk medicine can be found - salted ice. To make it you need to dissolve 4 tablespoons in 1 liter of water.

salt, pour the mixture into an ice sheet and freeze. Ice cubes should be applied to a sore spot, after the formation of melt water, wrap the knee with a woolen cloth for 4 hours.

Apply daily until it becomes easier.

Treatment of synovitis of the knee joint at home can be performed with the help of honey, unique in its properties.To prepare a home medicine you need:

1. - 1 kg of honey
2. -500 ml. vodka
3. -200 gr. rye
4. -2 liters. water
5. - 7 gr. the root of barberry

Among the methods, the treatment of synovitis of the knee joint at home, allows the use of special fees and teas for joints. Their preparation is not particularly difficult, and the composition does not hurt the body, helping to clear it of other diseases.

On the fire put a container of water and stirred rye, which should be boiled for about a quarter of an hour.

The received medicine should be taken by 3st. spoons 30 minutes before meals. You need to go through the course three times a year.

Prevention of synovitis of the knee joint

You can not insure yourself against everything in life, but you can prevent the appearance of a disease, observing a healthy lifestyle. Although life is not allowed to do this. Therefore, after the transfer of the disease, you need to reconsider the habits, the culture of physical health, and shoes.

Shoes with high heels should be hidden far away, before a special celebration and go to a more acceptable heel height, choose an orthopedic model, use orthopedic insoles.

It should also be reduced, and it is better to reduce too active sports that increase the burden on the knee, and also increase the risk of injury. For those who did not do sports before, on the contrary, it is necessary to engage in exercise therapy.

It is necessary to monitor the diet, that it would be rich in nutritional elements and vitamins.

Follow-up, after treatment - recovery. Strengthening and recovery is carried out under the supervision of a physician.Among exercises use:

• a bike
• sit-ups
• walking up to 6 km per hour
• jogging

Therapeutic gymnastics can be performed at home, starting from 5 minutes not earlier than seven days after the illness.

The initial set of procedures consists in raising the straightened legs only 15 cm from the floor level. Hold it in this position it takes 2 minutes.

Then you must carefully bend and unbend the foot, in the same initial position.

You can alternately lower and raise the leg, to start 5 times, and then gradually increase the amount to 15 to 10th occupation.

Effects

Untimely and incompetent treatment necessarily postpones its imprint on the joint, and also promotes the development of a number of concomitant. For example, periarthritis and phlegmon can develop.

This is impregnation of tissues with pus, as well as muscles, tendons, fiber and skin around the joint. It may develop purulent arthritis and panarthritis.

With the first disease, the pus spreads the outer shell of the joint capsule.

The second ailment captures the process of bone aging, the connection of the joint and cartilage.

To be ill with a synovitis is not very pleasant, as it is not only painful, but also burdensome. On the forums and the Internet, you can meet many reviews about the disease and treatment.

A source: https://glavvrach.com/sinovit-kolennogo-sustava/

Synovitis of the knee joint

Synovitis of the knee joint- inflammation of the synovial membrane of the joint, accompanied by accumulation of effusion. Synovitis may be aseptic or infectious, acute or chronic.

The cause of the disease is closed or open trauma, metabolic disorders, arthrosis, arthritis, hemophilia or allergies.

Noninfectious synovitis is manifested by an increase in the joint volume and aching pain, with an infectious increase in temperature and severe pain syndrome.

In the course of diagnosis, ultrasound, MRI, X-ray and other studies are used. Treatment is usually conservative.

Synovitis of the knee joint - inflammation of the inner membrane, as a result of which fluid accumulates in the joint.

Most often it develops as a result of trauma, the second place in the prevalence is occupied by synovitis with arthrosis of the knee joint.

Traumatic synovitis usually occurs in people of young and middle age, due to arthrosis - in elderly patients. Perhaps both acute and chronic course with periodic exacerbations.

At the same time, synovitis, especially infectious or often recurrent non-infectious, can aggravate the course of the underlying disease, cause the formation of hypertrophic villi, scarring, thickening, sclerosing or petrification of synovial sites shell.

And changes in the inner shell of the joint can have a negative effect on the condition of other intraarticular structures.

Causes of development and classification of synovitis of the knee joint

Normally, the cells of the inner shell of the joint produce a small amount of fluid. This fluid plays the role of a kind of lubricant, which facilitates the sliding of intra-articular structures relative to each other.

In addition, the synovial fluid supplies nutrients to the articular cartilage. When synovitis cells of the synovial membrane begin to secrete more fluid, its composition varies depending on the type of inflammation.

In the joint, an effusion is formed.

To provoke inflammation of the synovial membrane can be traumatic injuries, infections, congenital and acquired pathological changes in the joint and periarticular tissues, allergic reactions, metabolic disorders, endocrine diseases, autoimmune diseases and hemophilia. The process can proceed acutely or chronically, in the second case, exacerbations alternate with more or less prolonged remissions.

Given the nature of inflammation, two main types of synovitis of the knee joint are distinguished: noninfectious and infectious. With non-infectious inflammation is aseptic in nature, when infectious in the process involved pathogenic bacteria.

Infection can penetrate into the joint cavity from the external environment (for example, when the joint is injured), from neighboring tissues (when located nearby infected abrasions and wounds, furuncles, abscesses, phlegmon, etc.), with blood or lymph flow (with distant foci infection).

In most cases nonspecific pyogenic microorganisms act as the causative agent of the infectious synovitis of the knee joint: streptococci, staphylococci or pneumococci. In some cases, a specific infectious synovitis caused by pale treponema (with syphilis) or mycobacterium tuberculosis is detected.

The pathogenesis of noninfectious (aseptic) synovitis depends on the cause of the disease.

In case of traumatic injuries, inflammation arises from the constant irritation of the synovium by a damaged meniscus or pieces of cartilage.

A similar mechanism of development is also observed in arthrosis, in which the smoothness of the cartilage is disturbed, bone proliferation occurs, and so on.

With rheumatism and rheumatoid polyarthritis, synovitis develops under the action of antibodies that affect the synovial membrane. In some metabolic diseases, synovitis is formed due to the accumulation of metabolic products in the joint cavity.

In acute aseptic synovitis for several hours or several days, the joint increases in volume. Often there is a feeling of raspiraniya, possible non-intensive pain, worse with movements.

On examination, there is a marked disturbance in the shape of the joint, smoothing out the contours, and swelling at the sides of the patella. There may be a slight swelling of the soft tissues.

The presence, localization and severity of pain during palpation are determined by the underlying pathology.

Severity of symptoms depends on the amount of fluid in the joint. With the accumulation of a large number of effusions, the pain and sensation of bursting increase, the swelling increases, the skin of the joint becomes shiny, and sometimes there is hyperemia.

The nature of the effusion is usually determined by the cause of the disease.

In case of traumatic injuries and hemophilia, hemorrhagic effusion (the liquid is colored with blood), with other aseptic synovitis - serous (first the liquid is clear, with a strawish hue, later there is some darkening, the effusion turns yellow and less transparent).

Chronic aseptic synovitis proceeds wavy, exacerbations alternate with remissions. During the exacerbation the picture resembles a sharp aseptic synovitis, but the symptomatology is often smoothened, less bright. In a number of cases, a small amount of effusion is observed.

Pain and restriction of movements in the joint are caused by thickening of the synovial membrane. The severity of symptoms during remission depends on the underlying disease, duration and frequency of synovitis exacerbations.

There may be a restriction of movement, dull aching pain and rapid fatigue when walking.

For acute purulent synovitis is characterized by pronounced general and local symptoms. The joint is enlarged in volume, sharp pains, local hyperemia and hyperthermia are noted.

Movement is severely limited or virtually impossible due to intense pain syndrome. The general condition is broken, there is weakness, chills, weakness, nausea and fatigue.

Body temperature increased to febrile digits. In severe cases, hallucinations, delusions, confusion are possible. Palpation of the joint is very painful.

To confirm the diagnosis and identify the underlying disease, x-rays of the knee joint, arthropneumography, arthroscopy, CT of the knee joint, MRI, ultrasound and knee joint puncture followed by examination of effusion.

Depending on the form of synovitis, various microscopic and immunological studies of the punctate are carried out, and sowing is carried out on nutrient media.

If necessary, a synovial membrane biopsy is performed, the patient is referred for consultation to an allergist, infectionist, rheumatologist, hematologist, endocrinologist and other specialists.

Treatment of aseptic synovitis of the knee is usually outpatient, involves a puncture with evacuation of the effusion and immobilization of the limb with a gypsum lanceum, knee or pressure bandage for a period of for 5-7 days.

Long-term immobilization with synovitis is not indicated, since a prolonged lack of movement can lead to the development of joint stiffness.

Patients are assigned with exercise therapy, microwave therapy, electromagnetic therapy, electrophoresis with dimethylsulfoxide or hydrocortisone and ultrasound with anti-inflammatory drugs.

After elimination of acute inflammatory phenomena, paraffin, ozocerite, mud therapy and balneotherapy are used.

Therapeutic tactics in each case are determined individually, taking into account the severity of posttraumatic changes, the severity of secondary disorders (posttraumatic arthrosis), the prospects and risks of surgical intervention and other factors. According to the indications, the following operations are performed: reconstructive interventions on the bones, resection of menisci, restoration of ligaments, etc. In the postoperative period, medicinal correction of local metabolic disorders is carried out, rehabilitation measures are carried out.

With recurrent synovitis, pathogenetic therapy using glucocorticoids, calf cartilage extract, chymotrypsin, heparin, salicylates, ibuprofen and indomethacin is prescribed.

During the exacerbation from 3-4 days patients are referred to physiotherapy procedures: phonophoresis with corticosteroid drugs, UHF, magnetotherapy, electrophoresis with aprotinin, ketoprofen and heparin.

It should be borne in mind that heparin is contraindicated immediately after injuries and surgeries, as well as with clotting disorders.

In chronic synovitis with severe infiltration of the synovial membrane, inhibitors proteolytic enzymes, aprotinin and small doses of corticosteroids (dexamethasone, triamcinolone, hydrocortisone).

With the development of irreversible changes in the synovium (sclerosis, formation of petrificata and hypertrophied villi) perform a surgical intervention - partial, subtotal or total synovectomy.

In the postoperative period, immobilization is carried out, antibiotics, painkillers, exercise therapy and physiotherapy are prescribed.

A source: http://www.krasotaimedicina.ru/diseases/traumatology/knee-synovitis

Synovitis of the Knee: Causes of Symptoms and Treatment

The knee joint is a junction of the femoral and tibia by means of two cruciform and two lateral ligaments, anteriorly closed by a patella, attached to its own large ligament to the hummock tibia. Inside the joint, there are two cushioning pads - the outer and inner meniscus.The joint is surrounded by two shells:

• dense outer, called the articular bag;
• inner thin - it is called synovial.

Causes of synovitis of the knee joint

Causes of the disease can be:

1. injuries;
2. knee instability;
3. degenerative process - arthrosis;
4. infectious, reactive or allergenic arthritis;
5. gout;
6. specific infections (tuberculosis, syphilis, gonorrhea, etc.)
7. autoimmune processes;
8. endocrine disorders;
9. neurogenic and other factors.

How does the synovitis of the knee develop?

The synovial membrane constantly produces a small amount of fluid that lubricates the surface of the joint. When it becomes inflamed, excess fluid begins to be released.

If a purulent infection develops in the joint cavity, the synovitis passes into the septic form, which is extremely dangerous. Preventive measure - immediate evacuation of exudate from the cavity with the help of a puncture.

With a knee injury, an infection or mechanical damage to the membrane can occur:

• infectious arises because of hemarthrosis (hemorrhage in the joint) or because of severe damage to the soft tissues of the joint (more often - it is a penetrating wound).
• mechanical is caused by the appearance of an articular "mouse" (bone, cartilage and other joint tissues) or a meniscus rupture.

A non-infectious (aseptic) course of the disease is observed in the injuries.

Types of synovitis of the knee

Synovitis can be of several forms:

1. serous;
2. serous-haemorrhagic;
3. purulent-hemorrhagic;
4. purulent.

Current type is acute or chronic.

Chronic synovitis occurs due to frequent relapses:

• permanent hydroarthrosis leads to increased pressure inside the cavity;
• the synovium with time due to hypertrophy and fibrotic changes loses its absorbing capacity.

Symptoms of synovitis of the knee joint

1. The knee is rounded and becomes smooth: usually the pathology is one-sided, and asymmetry immediately catches the eye.
2. There may be redness and warming of the skin surface.
3. With the growth of edema, there are symptoms of stiffness.
4. There is a pain during walking and pressing on the calyx.
5. In acute course, temperature and poor overall health are possible.
6. Sometimes inguinal lymphonoduses increase.

Chronic synovitis is difficult to treat and leads to sad consequences:

• Further reduction of motor functions (gradually and completely it becomes impossible to bend the knee).
• Change in the composition of the synovial fluid.
• Disturbance of blood flow and metabolic processes.
• Symptoms of neuromuscular atrophy.
• The lean fluid is unable to protect the joint surfaces from friction, and deforming changes begin to occur in them, usually in the form of osteoarthritis.

Diagnosis of synovitis of the knee joint

The traumatologist, having inspected the knee and his feeling, directs to the radiography, which allows to reveal both traumatic damage and accumulation of fluid.

Additional diagnostics:

1. Ultrasound, MRI or CT;
2. arthroscopy;
3. blood chemistry.

To confirm the diagnosis, it is necessary to examine the composition of the synovial fluid with a puncture.With synovitis, the consistency and color of the liquid changes, in it can be found:

• admixtures of blood or pus, fibrin filaments, villi;
• urate salts, protein;
• pathogenic microbes.

If you have an aseptic form, you may need to consult other doctors: for example, a rheumatologist or an endocrinologist.

How to treat synovitis of the knee joint

The first measure is the removal of the exudate from the cavity by puncture (the fluid is immediately studied and sent for analysis).

1. The cavity is washed with an antiseptic.
2. The knee is immobilized with tires for about a week.

Next, a comprehensive treatment of synovitis of the knee joint.

Scheme of complex treatment of synovitis of the knee joint

• Symptoms of pain and inflammation are well eliminated by traditional NSAIDs (ibuprofen, indomethacin).
• Reduces the formation of effusion of glucocorticoids (hydrocortisone, dexamethasone).
• When an infection is detected (with the identification of a pathogen) antibiotics are prescribed:
  • cephalosporin, tetracycline, macrolides.
• In the absence of data on the pathogen, sulfanilamides are prescribed.
• Stimulation of blood circulation is produced by injections of heparin:
  • at an early stage, immediately after an injury or surgery, heparin is not used because of the danger of hemarthrosis.
• In chronic synovitis, proteolytic enzymes (trypsin, lysozyme) are helpful.
• Synovitis of the degenerative nature of the early stage can be treated with chondroprotectors:
  • arthra, alflutop, rumalon, teraflex.
• Local treatment with ointments (diclofenac, indovazinom, voltarenom) and antiseptics for wound treatment can even be used for the complex treatment of synovitis.
• After 3 to 4 days after the onset of the disease, you can start physiotherapy:
  • electrophoresis with hydrocortisone or dimexide, ozocerite and paraffin applications, mud therapy, massage, physiotherapy exercises.

Surgery

Indications for it are:

1. chronic chronic synovitis;
2. ineffectiveness of conservative treatment;
3. sclerotization, fibrosis or hypertrophy of the synovium.

The operation is performed as a partial or complete synovectomy:

• The Pierre cut is a layer-by-layer opening of the joint cavity.
• After the revision, all damaged menisci and foreign bodies are removed, and the cartilage is sanitized.
• Sites of pathology or the entire synovial membrane are removed.
• After the operation, hemostasis, hemostatic and anti-inflammatory therapy are performed.
• The limb is immobilized on the bus of Belera.
• Rehabilitation is started after 3 to 4 days.

Prevention of synovitis of the knee joint

To avoid the synovitis it is necessary:

1. Protect your knees from injury and increased stress.
2. When practicing traumatic sports, wear knee pads.
3. In time to treat infectious diseases.
4. A full-fledged diet, including also in the diet vitamins, amino acids, calcium and other important minerals.

A source: https://ZaSpiny.ru/tkani/sinovit-kolennogo-sustava.html

Synovitis of the knee joint - causes, symptoms and ways of treatment

Synovitis is a knee joint injury, which is expressed in the inflammation of the synovial membrane. In consequence of inflammation in the joint bag accumulates fluid, the so-called effusion.

Causes of appearance

The fluid in the joint is present even in the normal operation of the knee, it is the main source of nutrition for the cartilage tissue of the joint.

Also, the effusion plays the role of a lubricant, which is necessary for the normal operation of the joint during movement.

However, with synovitis, there is a sharp increase in its number, and as a consequence, an increased likelihood of infection and disruption of the knee joint.

There are several types of synovitis:

• Infectious and noninfectious (aseptic) synovitis (result from the ingress of bacteria, microbes, various allergic reactions, injuries and consequences of endocrine diseases);
• Acute and chronic synovitis (depending on the time and nature of the course of the disease).
• Serous, serous-hemorrhagic, purulent and purulent-hemorrhagic synovitis (according to the contents of the synovial bag)
• Suprapatellar and popliteal synovitis (based on the type of joint bag)

There are several causes of synovitis. The most common is a knee injury due to a stroke, bruise or other external impact. However, this is only one of the possible reasons.It is necessary to note also such reasons as:

1. Arthritis and arthrosis (synovitis in patients with such diseases is one of the side symptoms of the underlying disease);
2. Rheumatism;
3. Infectious diseases of the body (bacteria enter the fluid of the joint bag);
4. Allergic reaction;
5. Injuries of the knee (damage to the meniscus, ligaments), leading to the onset of synovitis;
6. Post-traumatic syndrome (the onset of synovitis is a natural reaction of the body to abnormalities in the work of the knee joint, various surgical interventions and external influences);
7. Metabolic disorders, autoimmune diseases, hemophilia.

All of the above signs can cause the synovitis of the knee joint separately or in a complex way to provoke its appearance.

Main symptoms

If we talk about synovitis as a consequence of trauma or external impact on the knee, the first symptoms can manifest only after a few hours, days or even a week. This should be noted when determining the cause of synovitis.

The first sign of the disease is an increase in the volume of the joint due to the accumulation of fluid in the joint bag.

There is a smoothing of the contours of the knee, its rounding and, as a consequence, deformation.

The second symptom is the limitation of mobility. The liquid accumulates in the knee, increasing its volume and hindering normal operation. This may cause pain.

However, this does not happen in all cases. The nature of the pain is dull, aching, small and medium intensity. The color of the knee remains unchanged, there is no increase in temperature.

In the knee, there is an acute pain of a pulsating nature. The knee seems to burst from the abundance of effusion. The color of the knee joint becomes bright red, an increase in temperature is observed.

The volume of the joint increases significantly, the skin becomes taut and shiny. Perhaps even the appearance of cyanosis.

Movements are extremely painful, there are signs of fever and general infectious poisoning of the body.

To clarify the diagnosis, it is necessary to take the periarticular fluid for analysis. It is examined for infections, check for transparency, the presence of protein and red blood cells. After puncture, a specialist can make an accurate diagnosis, focusing on the readings of the effusion.

The main stages of the disease

There are several stages / forms of the development of synovitis. Let us consider each of them in detail.

Minimization of knee joint synovitis

Can proceed painlessly. There is no pronounced inflammation, discomfort is manifested in the form of pulling sensations. The temperature is within the normal range.

Painful sensations are manifested only when palpation of the affected joint.

Identifying the disease on its own is quite difficult, and this is one of the dangers - a minimal synovitis can flow into a chronic one.

Acute synovitis of the knee joint

The acute form of the disease of the knee joint is accompanied by sharp pain and difficulty in the normal operation of the limb. In acute synovitis, there is often a purulent infection, accompanied by severe inflammation of the joint and an increase in temperature.

Secondary synovitis of the knee joint

This type of synovitis is observed in people diagnosed with arthritis, arthrosis, osteoarthritis. With these diseases, a special burden falls precisely on the joint, which leads to its deformation and accumulation of effusion.

A feature of the secondary synovitis of the knee joint is its repeatability. Knee deformity, traumatic pain, difficulty in movement and swelling - all symptoms occur and last for 3-7 days. Then all signs of the disease disappear, and return again after 2-3 months.

Moderate synovitis of the knee joint

Moderate synovitis is tricky in its relatively painless form of the course of the disease. Disturb the knee begins only a few days after receiving damage. There are always painful sensations, puffiness of the knee joint, difficulty in movement.

In acute form of moderate synovitis, fever may occur, chills occur, and fever symptoms occur.

But since all these signs are of a moderate nature, the patient has a false belief that the disease is in the process of being completed.

Due to the lack of treatment, a moderate synovitis very often changes into a chronic form of the disease.

Chronic synovitis of the knee joint

The form of chronic synovitis is quite rare and usually shows signs of minimal synovitis. There is rapid fatigue and limited movement, a crunch in the knee joint area. The number of dislocations increases, wear of the joint is observed.

With chronic synovitis, there are no signs of fever and infection of the body. However, the disease can be in remission for a long time, followed by a sharp deterioration and worsening of all the above signs.

Possible forms of the disease

Earlier, the species and the main stages of the synovitis of the knee joint were identified. We determined the main causes of synovitis. Let's talk more about the most common forms of the disease from the above factors.

Post-traumatic synovitis of the knee joint

As the name suggests, this is a form of synovitis arising from injury to the joint. Impact, bruise, and fall are the most common patterns of the onset of posttraumatic synovitis. Here it is possible to carry damage of a meniscus, ruptures and sprains of ligaments, dislocations, fractures.

For posttraumatic synovitis is characterized by pronounced signs of joint disease. There is swelling, acute pain and fever. The contours of the knee are smoothed out, movements cause severe pain.

Particular attention in the treatment should be given to the restoration of the integrity of joint damage. Post-traumatic synovitis may also occur as a result of chronic trauma. In this case, it proceeds as a moderate synovitis.

Reactive synovitis of the knee joint

Reactive synovitis is a consequence of various types of infections.

Intestinal, genito-urinary, respiratory, genital infections - all of them are the causes of reactive synovitis.

Also, reactive synovitis is a consequence of allergic reactions of the body, endocrine diseases, metabolic disorders.

Peculiarity of the disease - very often synovitis pathogens are not detected, because of this there is a weakening of immunity, and the immune system destroys its own connective tissue.

Treatment in this case is aimed at eliminating the causative agent, namely, the immune disease.

Exudative synovitis of the knee joint

Exudative synovitis is a disease accompanied by a significant accumulation of joint fluid.

This is due to pronounced instability of the knee joint.

Movement in this case is not carried out in full, and this is a factor for irritation of the synovial membrane, and fluid accumulation.

This form of synovitis occurs in patients with rheumatism, gout. With various injuries of joints and meniscus, low joint mobility or genetic disease of ligaments.

Treatment of exudative synovitis will be aimed at improving the mobility and work of the knee joint.

Villonodular synovitis of the knee joint

This type of disease is currently poorly understood. It is determined that the characteristic symptoms for the villonodular synovitis are pronounced pain sensations, difficulty in movement, arthritis and arthrosis of the knee joint.

Villonodular synovitis is classified as an autoimmune disease, which results in the formation of free cavities in the knee joint. In the cavity neoplasms are detected, and synovitis itself is characterized as a benign tumor disease.

Methods of treatment

There are several ways to treat synovitis. In most cases, a complex of puncture and further medication is needed. If the medicines do not give enough effect, specialists can resort to surgical intervention.

Puncture of knee joint

Puncture is both a diagnostic and therapeutic procedure.

Puncture consists in suctioning the excess of accumulated effusion, after which antibiotics are introduced into the loosened joint cavity to prevent infection.

Puncture without anesthesia.

The taken liquid is sent for analysis, and after determining the type and shape of the flowing synovitis, the specialist prescribes additional treatment.

After puncture it is necessary to provide rest to the knee joint. A complete lack of mobility can damage the joint, so it is recommended that the load be reduced to the maximum.

Medication

After determining the type and form of the course of the disease, the specialist prescribes medical treatment of synovitis. He also prescribes the necessary dose and duration of administration. The drugs prescribed for the treatment of synovitis of the knee joint are:

• Analgesics and other anti-inflammatory drugs:
  • Ibuprofen;
  • Diclofenac
  • Panoxen
• Antibiotics (for the destruction of infection):
  • Cefotaxime - injections into the muscle for one gram 3 times / day;
  • Vancomycin - in, g 4 times / day intramuscularly;
• Glucocorticosteroids:
  • Betamethasone;
  • Dexamethasone;
• Drugs for improving blood circulation microcirculation:

Surgery

As it was said earlier, chronic synovitis is not always amenable to drug treatment. In such cases, surgical intervention is necessary.

Also, indications for surgery can be when the knee joint reveals irreversible processes: the formation of foreign compounds, sclerosis and atrophy of connective tissue.

After surgery, anti-inflammatory and blood-resuscitative therapy is necessary. The joint must be restored with the help of physiotherapy and physiotherapy. It must be remembered that after surgery, a synovitis of the knee joint may recur.

Treatment with folk remedies

Treatment with folk methods without medication often leads only to an aggravation of the situation and the emergence of chronic synovitis. Here are a few folk remedies for the treatment of synovitis:

• Ointment from the grass comfrey;
• Rye broth;
• Decoction from the herbal collection;
• Lava oil;
• Tincture of a black nut.

Restoration after arthroscopy

The temporal characteristics of recovery after arthroscopy are different. The wound itself heals within 2-3 days. However, the knee joint after the operation should provide a long rehabilitation period, which can drag on for several months.

For the speedy return of joint mobility and comfort of movements, it is recommended to perform a set of exercises. Terms for different types of classes are set by the attending physician. It is necessary to understand that competent rehabilitation prevents the relapse of the disease and the development of complications.

Often to enhance the effect of the patient prescribed a course of physiotherapy. However, with synovitis, physiotherapy is an additional method and does not replace physical therapy.Here are some examples of exercises:

1. Incomplete flexion and extension of the knee in the supine position;
2. Slow raising and lowering of a straight leg in the supine position;
3. Strain of the muscles of the thigh and lower leg (in any position);
4. Compression of a flat object under the knee in the supine position on the back.

The synovitis of the knee joint is one of the most common leg diseases. Regardless of the type and form of the course of the disease, it is necessary to immediately contact a specialist and the purpose of treatment.

Synovitis can pass into a chronic form, the treatment of which may require surgical intervention, which will entail a long recovery period.

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