The knees are among the largest joints in humans, and they provide a very important function, namely, they help a person move normally. However, at the same time they are subject to significant stress, as during the day they have to support the weight of a person.
The design of the knee joint is quite complex, and any part of it can be injured and hurt from time to time. When inflammation occurs, synovitis of the knee is formed. Gradually, the joint begins to suffer greatly and eventually ceases to function normally. That is why if you experience pain in the knee joint, you should immediately consult a doctor for diagnosis and treatment.
Feature of the disease
Synovitis of the knee is a pathological process characterized by inflammation in the synovium. At the same time, fluid gradually accumulates in the joint bag.
Usually, the synovial membrane runs completely alongthroughout the articulation, and it contains many capillaries that provide nutrition to this articulation. The synovial membrane is responsible for the proper nutrition of cartilage tissue, releasing fluid.
When inflammation occurs, the process of secretion of joint fluid worsens, and it gradually becomes a lot. Inflammation can spread to the entire joint cavity or be partial.
Synovitis of the knee is often diagnosed in athletes. They are much more likely to suffer injuries. Also at risk are people with joint pathologies.
Main species
Synovitis of the knee is divided into infectious and aseptic. The first type of disease occurs as a result of the penetration of pathogens into the synovial membrane. Bacteria can enter the joint through the blood stream or directly into the wound.
Aseptic synovitis of the knee joint is formed as a result of injuries and various disorders in the body, such as diabetes. In addition, there is a classification depending on the characteristics of the liquid, namely:
- hemorrhagic;
- serous;
- serous hemorrhagic;
- purulent effusion.
Synovitis of the knee joint is divided into:
- primary;
- secondary;
- post-traumatic.
The primary form is associated with many other pathologies, such as arthritis in particular. Secondary occurs mainly after injury.
Such a pathology can form with absolutely any injury to the knee, as well as after surgery. This may cause the shell to activelyproduces fluid, which can accumulate in the joint capsules, causing synovitis.
Stages of disease
Synovitis of the knee joint is divided into acute and chronic stages. Acute is characterized by a rapid course, a pronounced clinical picture. At the same time, there is a significant increase in the size of the affected knee joint, pain, and hyperemia.
The chronic form is characterized by the presence of acute pain, periodic exacerbations, as well as somewhat erased symptoms.
Causes of occurrence
The anatomical features of the knee provide for the presence of a certain amount of synovial content that acts as a lubricant. Thanks to this, the articular parts slide easily without being exposed to too much abrasion.
The fluid is produced by certain cells that make up the synovial membrane. Under the influence of biologically active components, the norms of fluid production are violated.
Excessive amount of such exudate is a kind of reaction to an unfavorable factor. As a result, the permeability of the walls of the vessels increases, and the components of the blood plasma penetrate through them, but the reverse throughput is much lower. That is why fluid accumulates in the joint cavity, forming an infiltrate.
Ongoing inflammation can be stopped only by medical or surgical methods. In some cases, folk remedies give a good result. Retropatellar bursitis orsynovitis of the knee joint can occur for reasons such as:
- inflammatory diseases of the musculoskeletal system;
- endocrine pathology;
- rheumatism;
- diabetes;
- menopause;
- gout;
- eczema;
- injuries;
- bruises;
- burns;
- autoimmune diseases.
Staphylococci and streptococci are common causes of infectious synovitis. To avoid infection and the development of dangerous complications, at the first signs of the disease, you should consult a doctor.
Main symptoms
The development of symptoms of synovitis of the knee is not affected by the underlying cause of the disease, with the exception of only an acute infectious process. They are determined by the intensity of painful manifestations and the duration of the course. That is why the symptoms of the disease are considered strictly separately for the acute and chronic forms.
Acute synovitis is characterized by a fairly rapid course and an increase in symptoms. First of all, there is pain, which has certain characteristics, namely:
- not limited to just one dot;
- with acute synovitis, the knee hurts very much;
- there is an increase in painful manifestations in the morning and a weakening in the evening;
- decreases slightly at rest.
After a short period of time after the appearance of an intense pain syndrome, a slight swelling may form in the area of the affected joint. It is impossible to fully bend and unbend the affected joint,since such an action only begins to significantly increase the pain. Therefore, active movements in the joint area are somewhat limited.
If a person suffers from acute infectious synovitis, then local symptoms may be accompanied by signs of intoxication, headache, loss of appetite, fever, severe weakness. If timely treatment is not carried out, then this can provoke the formation of phlegmon of the knee joint.
Compared to the acute form of the disease, chronic synovitis is characterized by periods of remission and exacerbation. In the first few years, the painful manifestations are exactly the same as in the acute course. However, after some time, the articular cartilage begins to gradually collapse, and then the walls of the joint capsules become thinner. As a result of this:
- pains begin to increase;
- limited knee mobility;
- there is instability of the joints.
For the chronic form, a febrile symptom is unusual. During an exacerbation, the temperature may rise slightly. With proper treatment, a person remains only signs of moderate, which practically do not affect the quality of his life.
Diagnostics
Synovitis of the right knee is the most common, and this disease requires careful examination. The doctor cannot make a diagnosis only on the basis of the patient's complaints, since the symptoms of the disease are not specific. This may indicate the presence of many diseases. Diagnostic activities include:
- gathering anamnesis;
- examination by a specialist;
- lab test;
- instrumental techniques.
When diagnosing synovitis of the right knee, the joint is visually examined, palpation is performed, as well as special testing. Laboratory studies include immunological, biochemical and bacterial analysis. Additionally, synovial fluid and urine are examined.
Of the instrumental techniques, tomography, radiography, ultrasound and arthroscopy are shown. Sometimes they take a knee puncture and a biopsy of the synovial fluid. After carrying out all the required diagnostic measures, the patient will be diagnosed and appropriate treatment will be prescribed. In addition, an examination by narrow specialists may be required.
Feature of treatment
Treatment of synovitis of the knee is carried out depending on the severity of the pathology. The cause of the disease is of great importance. At the initial stage, doctors mainly prescribe conservative therapy, in particular, immobilization of the knee with an orthosis or plaster and taking medications. If there is a lot of joint fluid, blood or pus is present in it, then a therapeutic puncture is required. Chronic, chronic synovitis of the knee (4 years, for example), which periodically worries, is treated by surgical intervention.
The puncture is performed in order to clean the joint cavity from exudate and take it for histological analysis, andthen determine the cause of the disease and the nature of the inflammation. The procedure is performed using local anesthesia, so the patient does not feel any discomfort at all.
The doctor pierces the knee joint with a thin long needle and pumps out the contents from it. Then the affected joint is washed with disinfectants. In addition, if necessary, an antibacterial agent is introduced. To achieve the best result, it is necessary to repeat the procedure 3-4 times.
To eliminate the unpleasant symptoms of knee synovitis, treatment is carried out by using medications. They will help eliminate inflammation, swelling and soreness. Depending on the type of disease, drugs such as:
- painkillers;
- anti-inflammatory;
- antibiotics;
- corticosteroids;
- drugs to improve blood circulation;
- drugs to lower enzyme activity.
Also shown is immobilization of the limb to prevent destruction of the joint during movement. For this, a plaster bandage and various kinds of devices are used. The bandage should be selected by a qualified doctor, taking into account the severity of the course of the disease.
The patient may be shown a visit to physiotherapy that helps eliminate pain and inflammation in the synovial membrane, as well as normalize the blood circulation process. With synovitis, electrophoresis with medications, magnetotherapy, and laser therapy are often prescribed.treatment.
Warm compresses can be used for synovitis of the knee, but if the disease is non-infectious in nature. In the presence of an infection, warming is strictly prohibited. After eliminating inflammation and pain, the patient is selected for exercise therapy techniques and a therapeutic massage is prescribed to restore the normal function of the joint.
Exercise helps to normalize the blood circulation process, improve motor activity and further strengthen muscles. It is worth remembering that after immobilization, the joint is very weakened, so you should not overload it too much.
Medicated treatment
Drug treatment of synovitis of the knee allows you to get rid of provoking factors. There are a number of diseases in the presence of which it is not possible to completely cure the disease. These should include such as:
- arthritis;
- gout;
- osteoarthritis.
For each individual form of the disease, their own therapy regimens have been developed that allow you to return the full functioning of the joint.
For the treatment of acute traumatic synovitis, drugs such as:
- anti-inflammatory drugs (Ibuprofen, Diclofenac, Nimesulide);
- proton ulcer inhibitors (Omeprazole, Rabeprazole);
- antibacterials.
Drugs are used in tablet form or as injections. With very severe pain, injections are injected directly into the affected joint, as this allows much fastereliminate pain and inflammation. With proper therapy, unpleasant symptoms disappear in about 5-11 days. In addition, a severe injury may require surgery and subsequent traction of the leg.
Acute infectious synovitis is characterized by the fact that, in addition to excess fluid, purulent contents and pathogens accumulate inside the joint. They gradually destroy the ligaments, joint capsule, cartilage tissue. That is why it is important to timely puncture the knee joint with the introduction of disinfectants. After that, macrolides or penicillin antibiotics are prescribed. They have a high degree of effectiveness and help minimize side effects. It is recommended to use drugs such as Erythromycin, Amoxiclav, Azithromycin, Ampicillin.
To treat rheumatoid or psoriatic synovitis of the left knee (as well as the right one), it is necessary to treat the underlying disease. For this, complex therapy is used with the use of drugs such as:
- anti-inflammatory drugs along with Omeprazole;
- chondroprotectors;
- glucocorticoids.
To effectively eliminate the symptoms of knee synovitis, treatment should be carried out under the strict supervision of a rheumatologist. Self-therapy for this form of the disease is unacceptable.
Tuberculosis synovitis is a special form that develops against the background of pulmonary tuberculosis. Therapy is carried out in a specialized dispensary. After 9 months of treatment, you can completelyeliminate the signs of the disease.
Folk techniques
Treatment of knee synovitis with folk remedies is used quite often, as they, together with drug therapy, help to quickly and effectively cope with the existing problem. For this, tools such as:
- bear or badger fat;
- fresh cabbage leaves smeared with honey;
- plantain leaves;
- decoctions of medicinal plants;
- garlic ointment;
- comfrey ointment.
Treatment of synovitis of the knee with folk remedies is not able to completely eliminate pain, so it is used in combination with other methods. Timely therapy will quickly get rid of existing symptoms and prevent disability.
Many are interested in whether it is possible to warm the knee with synovitis and how exactly to do it. To do this, it is imperative to use only dry heat, and also use a compress with paraffin. This allows you to quickly and effectively eliminate pain. It is strictly forbidden to warm the knee with synovitis in case of an infectious lesion, as this will lead to its progression and the development of an abscess.
Saline compresses help to cope with inflammation and soreness. For their preparation, sea s alt is used, which must be diluted in water and moistened with a clean cloth in the prepared solution, then wring it out a little and apply to the affected area. All these techniques can be used when the integrity of the skin at the site of the lesion is not broken.
Surgicalinterference
Some patients wonder why knee synovitis won't go away. It may be that conservative means and methods do not bring the desired result. In this case, the doctor prescribes an operation, which is also needed in the chronic form of the disease.
Surgical intervention is performed to remove the affected area of the articular membrane, and sometimes it is completely excised. Often, the operation is performed using an arthroscope. This type of surgery is considered the most gentle.
Removal of a certain area of the synovial membrane is not dangerous at all, as it recovers quite quickly from the remaining area. When the entire membrane is excised, the risk of complications increases, and patients are at risk of getting arthrosis and arthritis.
Recovery period
How to treat synovitis of the knee, only a doctor can determine, however, regardless of the methods used, a rehabilitation period is required. For a speedy recovery, physiotherapy and exercise therapy are prescribed. Therapeutic exercises help improve blood circulation and strengthen muscles.
To do this, you need to perform stretching and relaxation exercises. Gradually increasing the amplitude of movements, making swings with increasing effort and constant tension. The rehabilitation period can be carried out on the third or fourth postoperative day using physiotherapy techniques. Patients are prescribed:
- magnetotherapy;
- electrophoresis;
- phonophoresis;
- heat therapy;
- mud treatment;
- UHF.
Magnetotherapy helps accelerate tissue repair, reducing swelling, acting on the body with a static field. The course of therapy is 10 days. During electrophoresis, the pathological process is affected by constant electrical impulses, which contribute to the rapid penetration of drugs to damaged tissues. This allows you to dissolve the fibrin threads and stop the process of degeneration of the synovial membrane. The course of therapy is 10 days.
Phonophoresis involves ultrasonic exposure in combination with the introduction of medications, which helps to reduce inflammation and eliminate swelling. The doctor selects the duration of treatment individually. After eliminating the signs of acute inflammation, UHF is required. This technique is based on the impact of a high-frequency field on the human body for faster recovery of affected tissues. The course of therapy is 5-8 days.
Complications
Untreated synovitis leads to a chronic process. In this case, the production of lubricating fluid stops, cartilage tissue is washed out and osteophytes are formed. This provokes problems with movement and the performance of the support function.
Injuries to the knee joints change posture and gait. When moving, a person tries not to rely too much on the affected limb. Due to spliced components, the leg cannot fully function. A person walks with a cane or crutches. Regionknee changes, it thickens in size.
Complications of this disease are very serious, especially when the purulent form occurs. In this case, arthrosis or arthritis begins to develop rapidly. The infection can penetrate into the periarticular tissues, which leads to the development of fistulas and purulent abscesses. Pathogenic microorganisms can penetrate into the systemic circulation, gradually turning into sepsis. A septic complication is fatal.
In the chronic form of the disease, the formation of secondary arthrosis can occur, as well as many other pathological changes. It is possible to avoid dangerous consequences only with timely treatment and compliance with medical recommendations. When treating synovitis of the knee, the reviews are mostly positive, since very good results can be achieved with timely therapy.
Prophylaxis
It is quite possible to prevent the occurrence of synovitis of the knee, the most important thing is to monitor your he alth and protect yourself from injury. To avoid the occurrence of inflammation, you must follow the following recommendations:
- treat inflammatory processes in time;
- See a doctor immediately if you have a knee injury;
- must wear knee pads when playing sports;
- should wear a brace when working hard.
Human nutrition is of great importance, as it must be balanced and he althy. It is necessary to comprehensively strengthen the immune system by consuming a lot of vitamins. It is not recommended to overeat, sohow excess weight is detrimental to the condition of the knees.
The prognosis of the disease largely depends on the cause, the characteristics of the course of the pathology, as well as the therapy. That is why you should not delay your visit to the doctor, as timely therapy increases the chances of a successful recovery.
