Synovitis of the knee: the symptoms, photo, treatment. How to treat synovitis

Synovitis - an inflammation of the synovial membranes that line the inside of the cavity of one or more large joints. When disease of synovial membranes fluid accumulates.

In 65-70% of cases suffer from knee, much less affected shoulder, elbow, ankle, hip joint. The disease is widespread, has many options for flow, occurs with equal frequency in children and adults of all age groups.

Most cases of synovitis in addition to pain, swelling and temporary disturbance of motor activity of the affected joint - does not get any more. But there are variants that can cause severe infectious and purulent process, sepsis (blood infection) and permanent disability.

What it is?

Gonarthromeningitis - a process of synovial membrane inflammation is accompanied by increased production of synovial fluid. Inflammation can be different for their own reasons, the flow, complications and methods of flow. Sometimes synovitis comes without a trace, but in some cases require long-term treatment, surgery and following rehabilitation.

Causes of

Provoke the inflammation of the synovial membrane may:

1. Injury, which result in constant irritation inside a joint casing or pieces of cartilage damaged meniscus.
2. Infections, which penetrate into the joint cavity from the external environment (at wound) or from adjacent tissues (with phlegmon, Abscesses, wounds, abrasions, boils etc.). Also pathogens can get into the joint of the remote sites of infection with the flow of lymph or blood.
3. Congenital and acquired diseases of the joint and periarticular tissues. They lead to the development of synovitis due to various reasons. For example, the disease develops with rheumatoid arthritis or rheumatism under the action of antibodies, which attack the synovium, while arthrosis - due to irritation of the cartilage of the shell, has lost its smooth surface, or bony growths.
4. Autoimmune diseases (lupus erythematosus, rheumatoid arthritis). The immune system perceives joint inner sheath of both the foreign agent and the antibody begin to gradually destroy it.
5. Metabolic disease. This reason is synovitis, because in the joint cavity accumulate metabolic products irritate skin.
6. Allergic reactions. By penetrating the joint capsule allergens are perceived as harmful antigens, and the immune system begins to produce antibodies, whereby there is an inflammation accompanied by excessive formation of synovial liquid.
7. Endocrine diseases. Hormonal disruptions lead to the fact that synovial fluid begins to be produced in large quantities. Because of this, it is developing inflammation of the joint shell.
8. Hemophilia. In this disease, there are constant bleeding into the joint cavity, causing inflammation.
9. Diseases of the nervous system. Lead to the emergence of severe stress, impairment or damage to the nerves in scoliosis, malignancy or fractures, as well as neuritis peripheral nerves.

Distinguish 2 steps were followed for disease:

1. Acute. Symptoms occur on the rise: swelling, pain, redness increases during the first few days.
2. Chronic (recurrent). Observed in the absence of an adequate and timely treatment of the disease; the main feature of chronic synovitis - dropsy and occasional mild pain.

Symptoms of an acute form

Acute synovitis of the knee may be accompanied by severe pain. Therefore, in case of suspicion of an infectious form of the disease is extremely important, as soon as possible to see a doctor, who will identify the infectious agent and prescribe the necessary treatment.

Symptoms that accompany acute purulent form:

• joint is increased in volume;
• fever;
• General condition is characterized by weakness and nausea;
• pain present in flexion-extension legs;
• redness in the knee area, which is hot during palpation.

disease with pyogenic infection particularly acute flows. Pathogenic bacteria often penetrate into the joint cavity together with the blood flow either through an open wound. Accumulated blood, pus and joint fluid can become a cause stretching the joint capsule, that causes pain.

Symptoms of infectious forms of the disease

The main aseptic type symptoms - the increase in the volume of the knee and the connection with the absence of pain. This phenomenon is caused by the fact that synovial fluid in the joint capsule synovial during stimulation, dramatically increases in the amount within a few hours. The resulting swelling in the knee prevents the free movement.

Symptoms of aseptic type have the following form:

• increase in volume occurs from several hours to 1-2 days;
• affected area has a high temperature;
• with pressure on the patellar bone it plunges into the joint, and then rises again;
• general weakness.

Reactive synovitis in the knee joint

Reactive gonarthromeningitis arises from intestinal, urogenital (genitourinary) or respiratory (respiratory) infection. The peculiarity of this kind of disease is that the pathogens in the joint cavity is not detected and the immune system starts to destroy its connective tissue.

often reactive synovitis of the knee begins with the acute form, but in the absence of proper treatment becomes chronic.

Symptoms of the chronic form

Chronic synovitis is the result of undertreated acute forms of disease and is characterized by symptoms of blunt. Painful manifestations have little concern to the patient. The knee has a small swelling, redness offline, there is a weak pain during flexion and walking.

Recognize chronic synovitis can on such grounds:

• The joint is often crunches, there are regular mikrovyvihi.
• Long walks are not possible, as there is an increased leg fatigue.
• The joint has a limited mobility.

In the chronic form no symptoms such as fever or fever. By inflammation may lead uncured rheumatism, allergic reactions, gout.

With the accumulation of effusion in the knee joint every year gradually accelerate the development of the inflammatory process. The patient shows signs hydrarthrosis (edema), and observed the pathological changes in the ligamentous apparatus.

What is synovitis of the knee joint: photos

The photo below shows how the disease manifests itself in humans.

Diagnostics

diagnosing program synovitis of the knee joint is accompanied by:

1. Performing CT, MRI, ultrasound of the knee joint, X-ray diffraction.
2. Puncture and biopsy - in severe cases.
3. A careful history data, on the basis of which it is possible to confirm or refute a number of diseases.
4. Professional inspection specialist - paltsipatsiya, general inspection, under the escort of tests.
5. Research, the KLA and urine examination sinovalnoy liquid.

Diagnosis - synovitis of the knee joint, with proper treatment, a victory in principle. However, please know that full recovery is possible only if serous and allergic synovitis. After transferring other types of synovitis, as a rule, it is joint stiffness, purulent formations, unfortunately, developing sepsis.

General principles of treatment of synovitis

the knee treatment is prescribed after a full examination and diagnosis. Method of treatment depends on the type of inflammation, synovitis stage of the knee joint and the individual characteristics of the organism.

Most often, an integrated approach, involving:

• puncture;
• immobilization of the affected joint;
• reception of drugs;
• physiotherapy;
• the use of traditional medicine.

If conservative treatment of synovitis of the knee do not bring the proper result, surgery is used.

Treatment of acute traumatic synovitis

Scheme of treatment of this form of synovitis can be divided into the following items:

1) Treatment of the injury - if it is an open fracture, the surgeon restores the normal position of the bones inside the joint, stitches damaged ligaments and portions of the capsule (if damaged) and the skin is sutured over wound.

2) When the open and closed fractures intra patient performed "skeletal traction" - through bones forming the joint, stretch and spokes hung heavy, in order to avoid their recurrence displacement. Typically, in this condition the patient should be up to 3 weeks if not previously scheduled for surgery.

3) If there is a synovitis symptoms in any period of time, the patient is prescribed:

• Nonsteroidal antiinflammatory drugs steps (NSAIDs) or intramuscularly in the form of tablets. The most frequently used: Diclofenac, Ketorolac (Ketoprofen, Ketorol), Ibuprofen, Nimesulide (Naiz).
• In order to eliminate side effects such as stomach ulcers and duodenal ulcers, prescribed method of "proton pump inhibitors" - rabeprazole, Omerpazol etc.
• If there is significant swelling of the knee or methods of examination revealed a large amount of fluid inside the joint, the patient is performed puncture and removed excessive volume.
• In the period "skeletal traction" patient send pass physiotherapy (photographic or magnetic) which promote the healing of tissues. they also produce anti-inflammatory effect that reduces the severity of synovitis.

4) After removing the spokes damaged leg gypsum, at least 6-8 weeks. During this period, synovitis is quite rare. And even if it occurs, it can be detected only by removing the plaster bandage. Treated by the above scheme.

Treatment of acute infectious synovitis

In this form, in addition to joint excess liquid is pus and bacteria, which gradually destroys the cartilage, ligament and capsule. Therefore, it is crucial to carry out a puncture of the knee joint with introduction of disinfecting solutions.

After the puncture, prescribe antibiotics and NSAIDs. Anti-inflammatory therapy is carried out similarly to that in acute traumatic synovitis. Antibiotics are prescribed penicillin or macrolides. They have the best effect with a minimum of side effects. Showing the following drugs:

macrolides:

• erythromycin;
• azithromycin;
• Josamycin (recommended for acceptance in children or pregnant women).

penicillins:

• amoxicillin;
• ampicillin;
• Amoxiclav (if the above medications are not effective or the patient has recently taken antibiotics).

Physiotherapy contraindicated in infectious processes, because they increase the number of bacteria. Therefore, this treatment method is not used in infectious synovitis.

How to treat and psoriatic rheumatoid synovitis

This synovitis develops against the background of rheumatoid arthritis. Therefore, to eliminate it is necessary to treat the symptoms of the underlying disease. Therapy should be carried out comprehensively, and include the following elements:

1. Chondroprotective agents - are used to keep the knee joint tissues. Effective and affordable drugs in this group is Chondroitin.
2. Anti-inflammatory treatment - if there is a good effect on NSAID, can be limited to the regular application of these medications in combination with omeprazole. If ineffective, the doctor prescribes hormones (prednisolone, hydrocortisone, and so on), calculating the dose individually.
3. Reducing the load on the affected joint - reduces pain. Unloading of the knee can be performed by recommending the patient to use a cane when walking.
4. Physiotherapy - anesthetic procedures aimed at the affected area. Allowed the use of any methods: UHF-therapy, photo and magnetic therapy, galvanization.

Treatment should be engaged rheumatologist. Alone is not recommended for treatment of this form of synovitis.

Treatment of tuberculous synovitis

This special form of synovitis, which only occurs as a complication of pulmonary tuberculosis. His treatment is carried out only in specialized clinics, along with the underlying disease. Handle with suspected presence of tuberculous synovitis to be tuberculotherapist or physician, who will send the patient to a specialist.

Usually this disease respond well to treatment. After 9 months of adequate therapy of tuberculous synovitis symptoms completely disappear.

Treatment of gouty synovitis

Gout, synovitis often arise due to deposition of uric acid salts in the joint cavity, capsules irritation and inflammation of the synovium. The most effective method of treatment is diet, which should be at:

• limit tea, coffee;
• exclude beans, mushrooms, beets and 'green' (onion, parsley, sorrel, lettuce and so on);
• excluding meat and fish products;
• eliminate alcohol;
• to include in the diet of mineral water (Narzan, Esentuki).

Drug therapy includes:

• NSAIDs in acute if they are ineffective - taking hormones (hydrocortisone or prednisolone).
• Colchicine - a drug designed to eliminate attacks.
• Permanent medication deducing uric acid from the organism, - allopurinol or Benzbromanon.

It should be noted that the use of drugs without dieting is useless in the treatment of gouty synovitis.

Therapy villous-nodular synovitis

This form of synovitis in nature represented a benign tumor. The most effective one for its removal would be the treatment of education. To do this, it is currently conducting arthroscopic surgery:

• make two small incisions of 1-2 cm;
• via their tumor removed;
• after the procedure sutured incisions;
• introduce instruments into the joint. One of them is a camera with a flashlight and the other - an electric knife or forceps.

Complications after such manipulations are very rare. They do not require long hospitalization - on average, the patient stays in the hospital 4-7 days.

Treatment of non-infectious synovitis (against the background of osteoarthritis)

Synovitis that occurs on a background of osteoarthritis, requires a special approach in the treatment. As used NPVSy primary therapy. However, this is not enough. To prevent recurrence of synovitis, it is necessary to improve the blood supply to the joint. The easiest way to do this with the help of physical therapy, which can be started from the first day of illness.

Treatment of folk remedies

This breach can be treated and folk remedies. But this should be done only after an accurate diagnosis is made and assigned to the main course of treatment. Traditional methods of disposal of this type of ailment well help during the initial stage of the disease.

The following folk remedies used to treat synovitis:

• fitootvarov of lotions;
• rubbing elbows liqueurs;
• reception decoctions;
• ointment herbal and animal fats.

But to begin to treat synovitis folk remedies can only be prescribed by a doctor. Even if the disease show all the symptoms, it is still self-medicate is not necessary. Such a violation should be treated only by a specialist, after the final diagnosis. Treatment is most effective if you combine "old wives' recipes with drug therapy.

Surgery

In case of failure of medical treatment for more information about the disease do arthroscopy - a surgical procedure with minimal intervention into the body. Using the arthroscope, the doctor clarifies the condition of the tissues of the joint capsule and precise diagnosis (excluding or confirming other diseases: gouty arthritis, arthrosis deformans, etc.). If necessary, a biopsy is performed modified synovial tissue.

Also arthroscopy may also be used for the treatment of synovitis: joint cavity after treatment medicines inside the swelling is reduced, and further possible to use conventional medicines.

Chronic synovitis of the knee joint with frequent relapses and nagging symptoms, as well as observable changes in the synovial shell (with tumor-like growths) - this is the indications for synovectomy (complete or partial removal of the modified tissue). In the postoperative period prescribed antibiotics and analgesics, physical therapy (the first day). joint immobility provide for a week, but is allowed to go from the second day after surgery.

LFK

Following the arthroscopy surgery on the joint or the conservative treatment is recommended to perform compound exercises for the early restoration of limb function (to start their studies in the terms designated physician):

1. Lie on her back, after which produce incomplete flexion and extension of the knee (10).
2. In the supine position under a knee compress any flat object with thickness up to 10 cm. (10 times).
3. In any position to stretch the muscles of femur and tibia (5-6 times).
4. Lie on your back, lift straight leg slowly to 40 cm. from the floor and lower it (10 times).
5. Lie on the side opposite to the side of the affected leg and then take up the injured leg (5 times).
6. I sit down on a chair and slightly raised above the floor surface attached to the injured leg 1-kilogram weight (5 times).
7. Standing on the affected leg and crouch produce rotational movement of the second leg (1 minute).

After stabilization of the recommended walks at a distance of 500-600 m. Several times a week at a slow speed, as well as to engage on the stationary bike.

Complications and prognosis

Prediction serious purulent septic and secondary synovitis. Complications can be panarthritis purulent, abscess lesions with cartilage and bone. In the case of reactive synovitis, a favorable prognosis.

Synovitis of the knee joint, the symptoms and the treatment that we have reviewed, refers to the relatively frequent disease. Often it is a secondary process, a complication of arthritis. Therefore, any pain, discomfort or swelling at movement should be under control.

In the event that within a few days the symptoms do not go - it is necessary to see a doctor.