Synovitis is a multifaceted disease that develops mainly in the knee joint. The knee is the joint with the largest number of synovial membranes, the largest joint surface and the most complex structure of the human body. Because the synovial membrane of the knee is extensive and located in the superficial part of the limb, there are more opportunities for injury and infection. Synovitis of the knee is a syndrome caused by sprains and various intra-articular injuries. It can cause temporary or long-term partial loss of labor force, which is harmful to both patients and society. Although there are many effective treatments, many patients are still not cured. Some young and middle-aged patients, in particular, have to bear many social and family responsibilities while suffering from long-term pain.
Most knee synovitis, is complicated by various knee injuries and other conditions, but it can also develop alone or secondary to knee osteoarthritis, the latter mostly in the elderly. In young adults, there is a history of acute knee trauma, and after the injury, mild edema, pain, limited motion, and claudication begin to occur in the knee. Synovial reactive effusion usually appears 6 – 8 hours after the injury, and the knee joint is significantly swollen, warm and afraid to move. Examination reveals limited flexion and extension of the knee, difficulty squatting with pain, and there may be limited pressure pain points around the joint with a positive floating patella test. Chronic injury to the synovium, which may not have a clear history of trauma, is characterized by tenderness and limitation of knee movement, swelling that does not subside, and fear of squatting. The swelling is persistent and prevents squatting. It increases with increased activity and decreases with rest. In patients with longstanding disease, hypertrophy of the knee capsule may be detected.
Synovitis of the knee, secondary to osteoarthritis of the knee in the elderly, is mainly due to mechanical biochemical irritation from cartilage degeneration and osteophytes, secondary to synovial edema, exudation and effusion of the knee joint. In young adults it is mostly due to acute trauma and chronic injury. Acute traumatic injuries include: knee sprains, meniscal injuries, lateral collateral or cruciate ligament injuries, intra-articular effusion or sometimes blood accumulation, manifesting as acute traumatic synovitis of the knee. Sometimes it can also be caused by simple knee synovial injury, such as a mild trauma, or a long-term chronic knee strain. In addition, wind, cold, and dampness can cause the knee joint to gradually swell and become dysfunctional, resulting in chronic knee synovitis.
Most synovitis of the knee is complicated by the above-mentioned knee injuries, but it can also develop alone or secondary to osteoarthritis of the knee, mostly in the elderly. In young adults, there is a history of acute knee trauma, and mild edema, pain, limited motion, and claudication begin to occur in the knee after the injury. Synovial reactive effusion usually appears 6-8 hours after the injury, and the knee joint is obviously swollen, warm and afraid to move.
Examination reveals limited knee flexion and extension, difficulty squatting with pain, and there may be limited pressure pain points around the joint with a positive floating patella test. Chronic injury to the synovium, which may not have a clear history of trauma, is characterized by tenderness and limitation of knee movement, persistent swelling, and fear of squatting. The swelling is persistent and prevents squatting. It increases with increased activity and decreases with rest. In patients with prolonged disease, hypertrophy of the knee capsule may be detected. For those who have a lot of fluid in the knee joint or those who have repeated fluid accumulation, joint fluid examination can be done, which can reflect the nature and severity of synovitis. Therefore, arthrocentesis and synovial fluid examination are important references for the diagnosis and differential diagnosis of synovitis of the knee.
General treatment methods.
1.Puncture therapy
When there is a large amount of joint fluid and tension, joint puncture can be performed to completely remove the fluid and blood, and inject sodium hyaluronate, which is the main component of synovial fluid, into the joint cavity.
2.Drug treatment
In the acute stage of synovial injury, stasis and blood accumulation, treatment is mainly to disperse stasis and produce new swelling, if there is inflammation, anti-inflammatory treatment is needed at the same time.
3.Fixation and rehabilitation training
Early bed rest, elevate the affected limb, use elastic bandage with pressure, and prohibit weight-bearing. During the treatment period, the quadriceps muscle can be flexed and contracted, and in the later stage, the flexion and extension exercises of the knee joint should be strengthened, which can play a positive role in eliminating joint effusion, preventing the atrophy of the quadriceps muscle, preventing recurrent synovitis, and restoring the extension and flexion function of the knee joint.
4.Local closure therapy
5.Physical therapy
Life conditioning for synovitis
1.Avoid long-term strenuous exercise
Long-term, excessive, strenuous sports or activities are one of the basic causes of synovial degeneration. Especially for weight-bearing joints (such as knee joints, hip joints), excessive movement increases the force on the joint surface and increases wear. Long-term strenuous exercise can also make the bones and surrounding soft tissues overly stressed and strained, resulting in local soft tissue damage and uneven stress on the bone and iliac, leading to osteophytes.
2.Appropriate physical exercise
Avoiding long-term strenuous exercise is not inactivity, on the contrary, proper physical exercise is one of the good ways to prevent osteophytes. Because the nutrition of joint cartilage comes from the joint fluid, and the joint fluid can only enter the cartilage by “squeezing” to promote the metabolism of cartilage. Proper exercise, especially joint exercise, can increase the pressure in the joint cavity, which is conducive to the penetration of joint fluid into the cartilage and reduce the degenerative changes in the articular cartilage, thus reducing or preventing synovitis, especially the hyperplasia and degenerative changes in the articular cartilage.
3, timely treatment of joint injuries
Joint injuries include soft tissue injuries and bone injuries. Osteomalacia of the joint is often directly related to intra-articular fractures. Incomplete fracture repositioning causes uneven articular cartilage surfaces, resulting in traumatic arthritis. For patients with intra-articular fractures, if timely treatment and anatomical repositioning can be done, the occurrence of traumatic arthritis and joint osteophytes can be completely avoided.
4.Weight reduction
Excess weight is one of the most important causes of osteophytes of the spine and joints. Excess weight accelerates the wear and tear of joint cartilage, causing uneven pressure on the articular cartilage surface, resulting in synovial inflammation.
Synovitis is a joint lesion in which the synovial membrane is stimulated to produce inflammation, resulting in the imbalance of secretion to form effusion. For a long time, it affects the normal life of patients, work, and brings a lot of trouble, some patients seek medical help everywhere, repeated episodes, painful, and even psychologically overshadowed, in the treatment of three links to pay attention to, timely and clear diagnosis; timely and effective comprehensive treatment; timely functional exercise, good Daily health care, and the usual functional exercise, to avoid another synovitis activities, to reduce joint damage, is the key to avoid synovitis attacks.