The largest and most mechanically complex joint in the human body is the knee joint. He / she shall bear the highest load when moving, it performs the function of maintaining the weight of the whole body, and is therefore particularly vulnerable to the development of various diseases and injuries. One of the most common joint pathology – synovitis. He has a different etiology and a lot of pain.
Synovitis is an inflammatory process, which is formed in the region of the synovial membrane of the biological material serving as a kind of depreciation. This shell synthesizes a special fluid that protects the bones of the joint from friction and injury. The total amount of liquid is about 2 mm, which is enough for normal functioning of the body.
If any damage to synovial membrane inflammation, contributing to the increase of fluids. This is a part of effusion, except water, hyaluronic acid and proteins may appear the bacteria, pus and red blood cells.
The pathological process occurs for various reasons, the most frequent are:
- Mechanical trauma or excessive physical loads.
- Allergy symptoms after eating an exotic food or medicines.
- Infectious diseases: syphilis, tuberculosis.
- Age-related changes provoked by a sedentary lifestyle.
- Rheumatic complications.
- Inflammation of the urinary system, intestinal infections, colds.
- Autoimmune and skin diseases: vasculitis, dermatopolimiozit, diabetes, psoriasis, sarcoidosis of the lungs.
Any of these reasons may contribute to the complication of inflammation of the knee joint. Often this happens against the background of low immunity and a sedentary lifestyle.
The types of synovitis
In medical practice, synovitis is classified depending on the reasons that caused the disease.
There are such types of synovitis of the knee joint:
- Primary – synovitis, is a manifestation of the underlying disease. It can be an arthrosis, arthritis, etc.
- Secondary – seen as a reaction to any pathology. As the primary disease can be allergic, infectious and viral disease, damage to the ligaments or menisci. To eliminate this form of synovitis is sufficient to eliminate the root cause of the disease.
- Post-traumatic form is the most common synovitis, caused by damage or injury to the knee joint – injury or hitting the kneecap. Such injury initiates a process of accelerated synthesis of synovial (synovial) fluid
Any of these types of synovitis is one of two large groups, which is determined by the method of treatment of inflammation:
- Aseptic – developed without the participation of microorganisms with endocrine, autoimmune, rheumatic, post-traumatic diseases.
- Infectious synovitis – it is caused by bacteria, protozoa fungi, viruses. Often, the cause of infectious forms are E. coli, Streptococcus pneumoniae, Brucella, tubercle Bacillus. Pathogenic microflora gets into the joint via the bloodstream and forms the focus of inflammation.
- Allergic – synovitis, which is a reaction to contact with allergens.
The definition of all these groups and types allows you to assign your most competent treatment, which is effective for certain types of synovitis.
The disease may be acute, subacute, and chronic.
The symptoms of synovitis
Most often synovitis symptoms begin to manifest themselves after three days of penetration of infection in the joint or injury.
Obvious signs of pathology are:
- pain pulling character;
- the increase and the change in the shape of the joint;
- difficulty of movement;
- hyperemia (redness) of the skin.
The severity of these manifestations depends on a number of factors. Very often the disease is complicated by General malaise, fever, malfunction of other organs.
The symptoms of acute synovitis of the knee joint
The time development of the acute form of disease – from several hours to several days.
If the inflammation is of infectious nature, then in acute synovitis, the doctor notes these symptoms:
- The joint area is greatly increased in volume.
- The swelling is red, hot to the touch.
- Bend: straighten your leg hurts when walking there is lameness.
- Overall health: weakness, muscle pain, slight nausea due to intoxication, the body temperature of 38 degrees and above.
Signs of disease are growing rapidly, swelling the joint and the deterioration of health, usually develop within a few hours.
Please note: the most discomfort and soreness delivers purulent infection, indicating a rapidly evolving disease.
For acute purulent synovitis of the knee joint characterized by:
- quite a strong pain, having a bursting or throbbing character;
- severe swelling of the joint;
- severe pain when attempting to bend/straighten leg;
- redness or blue discoloration of the skin over the joint, the appearance on the characteristic gloss;
- the increase in temperature in the hearth of inflammation;
- pronounced General signs of toxicity (significant increase in body temperature, fever, severe malaise and weakness, sometimes raving);
- necrotic processes in the ligaments and synovial bags knee joint.
As rapidly can also develop symptoms of pathology in the form of traumatic synovitis of the knee joint. When it comes to the fore increasing swelling, tenderness, limitation of motion in the knee. Patient complains of General malaise, he reveals a slight increase in temperature and reaction acceleration of erythrocyte sedimentation.
For non-infectious synovitis more stretched for time, the disease takes from a few days to a few weeks. Initially a person feels a pain that occurs when the load on the damaged joint. Typically, this initial soreness is alone. Slowly but steadily increasing swelling, joint deformity and pain.
In the presence of such symptoms should not delay a visit to the therapist, who, based on history, will be sent for consultation to a rheumatologist, the surgeon or the traumatologist-orthopedist.
The symptoms of chronic synovitis
Chronic synovitis of the knee joint – a very rare occurrence, it is the result of adolecense acute pathology and is characterized by blunted symptoms. Painful symptoms have little concern for the patient. Knee has a little swelling, redness absent, felt weak pain when bending and walking.
To recognize chronic synovitis is one of the following:
- The joint is often crunches, there are regular microbewiki.
- Long walks are not possible, as there is fatigue of the legs.
- Joint has limited mobility.
In the chronic form there are no symptoms such as increased body temperature or fever. To inflammation can lead untreated rheumatic fever, allergic reaction, gout.
Every year the accumulation of the effusion inside the knee joint gradually accelerate the development of the inflammatory process. The patient shows signs of hydrarthrosis (dropsy), and observed pathological changes in the ligaments.
Diagnosis of synovitis
Diagnosis enables a certain behavior specialist. Initially carried out a visual inspection, which is determined by the degree of swelling, deformity, tenderness and limitation level of mobility. In medical record of the patient contains information about the causes of that inflammation, the body condition and the disease and infection.
Next, the technician assigns a laboratory study, it involves the change of biochemical blood analysis from a vein, urinalysis, immunological examination and sampling of synovial fluid from inflamed knee.
It is important! For a more accurate diagnosis can be assigned to ultrasound of the knee, x-ray, arthroscopy.
General principles of treatment of synovitis
Treatment of a knee joint is assigned after a complete examination and diagnosis. The method of treatment depends on the type of inflammation, the stage of development of synovitis of the knee joint and individual features of the organism.
Most often used an integrated approach involving:
- immobilization of the damaged joint;
- the usage of medical preparations;
- the use of traditional medicine.
If conservative methods of treatment of synovitis of the knee joint do not bring proper results, apply surgical intervention.
Puncture performs both therapeutic and diagnostic value. First, with its help it is possible to determine the type and cause of the pathological process. Secondly, by means of puncture can extract from the cavity of excess synovial fluid, and thus “unload” the joint, relieve pain and return mobility.
For the procedure a surgeon prepares a syringe with a special thin and long needle and antibiotic solution. The removal of fluid, generally performed without anesthesia. Manipulation requires a certain experience because the doctor it’s important to get inside the joint capsule. After the selection of the liquid is carried out intra-articular administration of antibiotics.
The first thing the attending physician recommends biopsy – a considerable reduction in the load on the joint. While complete rest is rarely necessary, therefore, to treat synovitis you can use a knee brace or immobilizing bandage.
In exceptional cases, can be superimposed plaster splint or splint. The maximum period of immobilization for 7 days.
Drug treatment of synovitis of the knee joint
The main objective of drug therapy – elimination of signs of inflammation, prevention of complications and reduced recurrence of disease.
For the treatment of synovitis of the knee joint appointed by such drugs:
- NSAIDs – they reduce inflammation and relieve pain. For the treatment of oedematous surface recommended gels and ointments Diclofenac, Indomethacin or Voltaren. Their action is enhanced by the appointment of tablets and injectable forms of NSAIDs.
- Inhibitors, can reduce the activity of proteolytic enzymes – Trasilol and Gordox. They are administered in protracted and chronic form of the disease.
- Corticosteroids. If the inflammation is started, and has severe manifestations may be assigned to Dexamethasone or Kenalog-40 for insertion into the joint.
- Antibiotics, topical in the treatment of infectious synovitis of the knee joint. They recommend the use along with the probiotics necessary to maintain microflora in the digestive tract.
- ATP, vitamins, nicotinic acid, helps to normalize microcirculation of fluids.
Physical therapy in synovitis
About the third day of the disease the patient is prescribed a course of physical therapy.
With the help of this technique, exposure is possible to achieve such goals:
- To eliminate the pain.
- To restore mobility.
- Strengthen the lymphatic tissues.
- Improve blood circulation the inflamed region.
This may be involved:
- SMT (therapy sinusoidal modulated currents). SMT – therapy, which is prescribed for acute pain, at the beginning of the development of the disease. When exposed to CM-currents is a loss of sensitivity of pain receptors. there is a surge of blood, articular cartilage begins to recover. Thermal treatment is conducted only on the first stage of the disease.
- Magnetic therapy – the impact on the affected area by the method of low-frequency pulses. Is assigned only to older patients, with chronic synovitis. Using the procedure fails to improve mobility, relieve pain, promote rehabilitation of damaged tissue and cartilage
- Electrophoresis is the most effective method of treatment, which, by means of electric impulses delivers medication directly into the joint. Using the fast feed medication in the inflamed area, it is possible to achieve maximum results: swelling comes down, the joint becomes more mobile, eliminates pain, recovery is much faster.
Traditional medicine in the treatment of synovitis of the knee joint
To promote healing and relieving symptoms of synovitis can be successfully be used in traditional medicines.
Please note! Traditional methods of therapy used only in complex with traditional treatment and only in consultation with your doctor!
The most effective means considered to be:
- Salt icemade from 4 tbsp of salt and 1 liter of water. The resulting pieces of ice applied to the inflamed joint to rastarivanie, the water is not clean. After a bad knee wrap for 3-4 hours a woolen scarf.
- A decoction of Bay leaf. It is prepared from 300 ml. of water and 10 Laurel leaves that are boiled for 5 minutes, and then insist for 3 hours. Drink before bedtime for three days then doing 7 days break and again drink the 3 days. Repeat the course next year. The prepared broth can not be used on the second day. It is possible also to make the bath and rubdown.
- The comfrey. From Cup chopped plants and 200 gr. pork fat, prepare an ointment for what ingredients twist in a meat grinder and insist week in a cool place. Ointment RUB the sore spots. Also in the treatment of synovitis of the knee joint can prepare a tincture for rubbing. For it take 500 ml of vodka and insist in it 150 gr. crushed roots of comfrey.
Surgical treatment of synovitis – an extreme measure, resorted to it only in those cases where the disease is taking on running form, traditional methods do not give any result. When surgical intervention on the damaged joint – synovectomy – carry out the removal of meniscus, foreign bodies, destroyed areas in the synovial membrane.
The postoperative period involves complete rest, the ingestion of various drugs, development of joint courses of physical therapy.
Prevention of synovitis of the knee joint
Any disease easier to prevent than to experience pain, discomfort and engage in long-term treatment. Prevention of inflammation of the knee joint lies in timely treatment to the doctor and treatment at the initial stage of the disease.
To reduce the risk of joint disease will help the following measures:
- Every trauma and injury must be treated from a specialist to prevent complications.
- With existing chronic and infectious disease should listen to the body and consult a doctor at the first sign of alarm.
- Try to wear comfortable shoes and during exercise – locking joints knee pads.
To prevent the disease is not difficult, it is important to adhere to certain rules, and to timely refer to a specialist. Detected early synovitis, easily treatable, and brings the least discomfort. If the patient is not in a hurry to take advice from physician and self-medicates, it is likely that the disease will become severe, cause a number of severe complications or even be life-threatening, as it will develop sepsis on the background of purulent inflammation.
Chumachenko Olga, medical columnist