synovitis

Introduction

Introduction to synovitis Synovitis is a multiple disease that occurs mainly in the knee joint. The knee joint is the joint with the largest synovial membrane, the largest joint surface and the most complicated structure. Because the synovial membrane of the knee joint is extensive and located in the shallow part of the limb surface, it has more chances of injury and infection. The main cause of knee joint synovitis is knee joint syndrome. A group of syndromes caused by knee sprains and various intra-articular injuries. Knee synovitis is mainly caused by knee sprains and various intra-articular injuries, such as meniscus injury, synovial damage, cruciate ligament or collateral ligament injury, intra-articular fluid or sometimes hemorrhage, showing acute Traumatic synovitis of the knee. Intra-articular injury and dislocation can sometimes be caused by simple knee joint synovial injury, such as mild trauma, or chronic chronic knee strain. Coupled with wind, cold, and dampness, the knee joint gradually appears swelling and dysfunction, and chronic knee synovitis is formed. basic knowledge Sickness ratio: 0.1% Susceptible people: no specific population Mode of infection: non-infectious Complications: synovial sarcoma Achilles tendon bursitis

Cause

Cause of synovitis

Young man with synovitis

Young people, knee synovitis is mainly caused by knee sprains and a variety of intra-articular injuries, such as meniscus injury, synovial damage, cruciate ligament or collateral ligament injury, intra-articular fluid or sometimes blood, It is characterized by acute knee traumatic synovitis. Intra-articular injury and dislocation can sometimes be caused by simple knee joint synovial injury, such as mild trauma, or chronic chronic knee strain. Coupled with wind, cold, and dampness, the knee joint gradually appears swelling and dysfunction, and chronic knee synovitis is formed. Another reason is infection, which is common in synovial tuberculosis. Generally speaking, the blood vessels in the synovial membrane are rich, the blood circulation is good, and the resistance to bacteria is strong. However, in the case of infection with tuberculosis, the disease progresses slowly, Symptoms are good and bad, this is one of the chronic synovitis of the knee.

Synovitis in the elderly

Knee synovitis, in the elderly more secondary to knee osteoarthritis, mainly due to mechanical biochemical stimulation of cartilage degeneration and bone hyperplasia, secondary knee synovial edema, exudation and accumulation Liquid, etc.

Excessive exercise

The swelling of the joints is mainly caused by swelling after excessive exercise, and the pain is different. Non-swelling type, mainly joint pain, often accompanied by mild swelling. Studies have confirmed that the two types are essentially the same, except that the degree of synovial pathology varies. The researchers found that when the knee joint was subjected to excessive movement for a long time, the synovial tissue was congested and edematous, and the exudation of red, white blood cells and cellulose was positively correlated with the increase of intra-articular pressure and the decrease of oxygen partial pressure, and when exudation occurred. When the speed exceeds the compensatory absorption rate of the synovial membrane, the joint effusion, and thus the intra-articular pressure continues to rise, the oxygen partial pressure continues to decline in the vicious circle, and the chronic synovial inflammation such as degeneration of the synovial membrane is formed. It is believed that after excessive exercise, the occurrence of traumatic synovitis is not only related to repeated slamming of the articular surface, damage of the joint capsule, but also plays an important role in the development and outcome of the disease course.

After synovial injury of the knee joint, the synovial membrane showed hyperemia, edema and neutrophil infiltration. Synovial vasodilation, plasma and extracellular osmosis, produce a large amount of exudate, while synovial cells are active, producing a large amount of mucin. The exudate contains red blood cells, white blood cells, bilirubin, fat, mucin and cellulose. In severe cases, the joint effusion is bloody. Joint swelling and limited mobility. If not treated in time, synovial hypertrophy, intra-articular adhesions and cartilage degeneration may occur in the advanced stage. If the injury is repeated, the synovial reaction can be converted to chronic, manifested by lymphocyte and plasma cell infiltration. These phenomena are all non-specific synovial responses. When severe damage causes synovial defects, it heals faster, which is due to the regeneration and proliferation of synovial cells, while other tissues and cells can also biochemically become synovial cells. However, severe proliferative knee arthritis, synovial villi edema, hypertrophy, thickening, the formation of many different sizes, different shapes of synovial folds, fibrous tissue under the synovial connective tissue group, and aging of synovial tissue biology, etc. , the synovial tissue regeneration and repair ability is significantly reduced.

Prevention

Synovitis prevention

(1) Avoid excessive knee activity and strain, especially those with severe lower limbs (such as dancers, athletes, porters, etc.) should pay more attention to work and rest, to prevent tissue damage caused by excessive force, otherwise, with age Growth, it is prone to bone hyperplasia.

(2) When there is a fracture in the knee joint, it is necessary to go to the hospital for treatment in time, so as to make the fracture end reach the requirement of anatomical reduction. If the reset is not satisfactory, surgical treatment should be taken in time.

(3) Those who are too obese should properly control the diet, pay attention to adjusting the diet structure, reduce calorie intake, control the body weight within the appropriate range, and reduce the pressure and wear on the joints.

(4) The elderly can appropriately supplement calcium and vitamin D drugs that are closely related to bone metabolism, and engage in moderate physical exercise to slow down the aging and degenerative changes of bone tissue.

Complication

Synovitis complications Complications Synovial sarcoma Achilles tendon bursitis

Synovitis is a sterilized inflammation caused by poor microcirculation. The main symptom is the accumulation of fluid. The synovial membrane is a layer of membranous tissue surrounding the joint. It is not only a layer of tissue that protects the joint, but also Synovial fluid is also produced, providing "lubricating fluid" for joint activity. The production and absorption of joint fluid is a dynamic balance. When there is a reabsorption of joint fluid, the joint balance is broken due to the generation and absorption dynamics of joint fluid, and the joint fluid is more than reabsorbed. water".

Symptom

Symptoms of synovitis Common symptoms Knee joints can not fully extend knee joint pain Joint swelling Joint effusion Joint swelling and pain Inflammatory damage Joint fluid exudation Synovial inflammation

Once symptom

Mainly joint pain, joint swelling is not significant or accompanied by mild swelling, walking and squeaking, and joint pain or discomfort when going up and down or exerting force, long-term walking joints have a feeling of fever, stiffness, and increased pain.

Second degree symptom

The joints are swollen, the pain is not significant, there is discomfort in the squat or bending, individual patients are accompanied by muscle atrophy, and swelling after excessive exercise. In the morning, the symptoms are lighter, and the night is aggravated. You can't walk for a long time. If you walk more, the calf will have a feeling of soreness and increased fluid.

Severe symptoms

The joints are swollen and painful, accompanied by effusion, bone spurs, and free bone.

Bone hyperplasia symptoms

Joint pain, swelling is remarkable, the upper and lower floors are more obvious, the stiffness is not flexible, and there is a creaking sound when flowing. The patella softening type: the joints are sour and weak when walking, and the soft legs are not able to stretch and bend when running. The pain worsened as you went downstairs and the symptoms disappeared at rest.

Meniscus injury

The legs are easy to walk when walking. Occasionally, the legs will not be able to walk, and it feels like something is stuck in the legs. It takes a little rest to return to normal. Generally, people who love sports or people with special occupations have a higher probability of injury. Sometimes accompanied by thigh muscle atrophy.

Synovial inflammation in children

Most of the affected parts of the child are in the hip joint. The child will have a pain when sitting, moving, walking, and there will be a lameness (a limping). The onset time is more than a period of time after the cold. Parents are not easy to find or misdiagnosed in the early stage of the disease.

There are also some special groups of people with synovial inflammation in the hip joints, cheekbones, ankles and wrists. The symptoms are different from other joints, but the pathology is basically the same.

Examine

Synovitis check

For patients with multiple knee joint effusions or repeated fluid accumulation, joint effusion examination can be done.

Joint puncture and synovial fluid examination have important reference value for the diagnosis and differential diagnosis of knee joint synovitis.

Diagnosis

Diagnosis and differentiation of synovitis

For patients with multiple knee effusions or recurrent effusions, joint effusion examination can be performed, which can reflect the nature and severity of synovitis. Therefore, joint puncture and synovial fluid examination have important reference value for the diagnosis and differential diagnosis of knee joint synovitis. Knee joint trauma synovitis, easily misdiagnosed as "benign joint pain", given simple symptomatic treatment, poor results and often left behind sequelae. Because the degree of synovial lesions and synovial fluid exudation changes positively with the increase of intra-articular pressure and oxygen partial pressure, the oxygen partial pressure in the joint cavity is increased, the intra-articular pressure is reduced, and inflammation absorption and synovial repair are promoted. effect.

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