Synovitis of the knee joint: symptoms, treatment, causes, diagnosis

What is it? Synovitis is an inflammatory lesion of the synovial membrane, which in turn covers the joint.

Its main physiological purpose is to protect joints from friction( articular surfaces should not rub against each other).

Against the backdrop of the inflammatory process, exudate( an inflammable fluid) is formed, which accumulates in the joint cavity.

According to statistical data, the synovitis of the knee joint is most often diagnosed. This is due to increased mechanical stress on it, which leads to traumatization of synovia, creating conditions for the development of the inflammatory process.

Causes of synovitis

The main causes that lead to this disease are as follows:

1. 1) Traumatic injury of the knee as a result of playing sports, falls, bumps, bruises, etc.
   
2. 2) The ingress of microorganisms into articular tissues, including the synovial membrane. So, synovitis often develops as a complication of colds( acute respiratory infections)
   
3. 3) Autoimmune diseases that are characterized by the activation of the immune system against its own synovia antigens. Therefore, synovitis usually develops on the background of allergic reactions, as well as as a result of systemic diseases of connective tissue( rheumatoid arthritis, systemic lupus erythematosus, rheumatism, etc.)
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4. 4) Metabolic disorders characterized by the accumulation of certain chemical substances in the joint cavity. Thus, with gout, there is an increased deposition of salts of uric acid in the joint cavity.
   
5. 5) Allergic reactions.

Read also, bursitis of the knee joint and its treatment.

Classification of

Synovitis has been classified from the etiological point of view into the following types:

• infectious
  
• aseptic
  
• allergic.

In the first case, inflammation of the synovial membrane is associated with the ingress of various microorganisms into the joint cavity. This can occur as a result of direct injury to the joint( open trauma), the introduction of pathogenic microorganisms with blood flow from the foci of chronic infection( diseases of the ENT organs, caries and others).

The most common cause of infectious inflammation are microorganisms such as:

• pneumococci
  
• streptococci
  
• staphylococci
  
• herpes viruses
  
• influenza viruses
  
• mycobacterium tuberculosis
  
• pale treponema( syphilitic synovitis).

Thus, infectious synovitis of the knee joint can be both specific and nonspecific. This circumstance must be taken into account in the treatment of this disease. Aseptic synovitis is also characterized by the development of an inflammatory reaction, however, no microorganisms are detected in the exudate. At its core, it is a reactive synovitis that develops against the background of the following causative factors:

• joint trauma
  
• metabolic disturbances
  
• autoimmune disorders.

Allergic synovitis develops in predisposed patients. This is a special reaction of the immune system to ordinary substances, which in some people act as allergens. They can get inhaled, parenterally, and also with various food products.


The disease occurs with obvious clinical manifestations and, as a rule, is well amenable to pathogenetic therapy. In some cases, synovitis in acute course may occur with an increase in body temperature.

Chronic inflammation of the synovium is usually a consequence of acute synovitis, which is inadequately treated. Also, it may be predisposed to late appeals to the doctor or self-treatment, which the patient himself appoints.

Symptoms of synovitis of the knee joint

Synovitis of the knee joint, the main symptoms and the first signs of which is the increase of the joint edema, which is manifested by an increase in its circumference, and also:

• joint defogging, that is, a change in its shape due to accumulation of exudate
  
• redness of the skin over the affected joint
  
• local increase in temperature over the affected joint
  
• joint pain associated with the development of the inflammatory reaction
  
• a violation of its function, which is manifested in limitedmobility, pain on the background of movement. This causes the patient to spare the patient's joint, against which there is lameness in the affected knee joint.

See also, symptoms of arthrosis of the knee joint.

Diagnosis

Diagnostic search in the presence of articular pain in the knee joint includes a number of additional research methods that can exclude a number of diseases that show symptoms similar to synovitis.

These are the following:

• deforming osteoarthritis
  
• rheumatoid arthritis
  
• rheumatism with articular syndrome
  
• gout, etc.

In connection with this recommended research are the following:

• general clinical blood test
  
• infectious examination - polymerase chain reaction or serological analysis to the most frequent infectious agents
  
• X-ray of the joint
  
• ultrasound of the joint
  
• puncture of the affected joint and microscopic examination of exudate
  
• exudate seeding on specialenvironment( bacteriological research), which can be supplemented by the definition of sensationantibiotic
  
• , the determination of rheumatoid factor, seromucoid, sialic acids, etc. in the blood.
  
• biochemical blood test( first of all it is necessary to determine uric acid to exclude gout, as well as other substances, the level of which can change against the background of metabolic disorders).

Treatment of synovitis

First of all, the treatment of synovitis of the knee joint consists of the following measures:

1. 1) Creation of rest to the affected joint. This is achieved through elastic bandaging, limiting the load on the joint( using crutches, walking sticks, if it is a lower limb), using fixation bandages, etc.
   
2. 2) Conservative therapy with the use of both pathogenetic and symptomatic means. The groups of drugs used depend on the cause that led to the development of the disease.

Conservative therapy shows:

1. 1) Non-steroidal anti-inflammatory drugs that reduce the severity of pain and effectively eliminate the pathogenetic links of inflammation. They can be used as topical( ointments and creams applied to the joint), and systemically( tablets, powders, injections).These include Diclofenac, Ketanovi, Ibuprofen, Meloxicam and other
   
2. 2) Protease inhibitors that reduce the severity of damage to the synovium. Representatives of these drugs are Contrikal, Gordoks and others
   
3. 3) Antibiotics in the presence of infectious synovitis
   
4. 4) Antidotal drugs in the case of the development of synovitis against the background of gout
   
5. 5) Corticosteroids, which are shown with an active inflammatory process to reduce the negative effect of etiological factors on the joint.

Read also, treatment of arthritis of the knee joint.

Consequences of

Complications of synovitis of the knee joint develop in the case of late diagnosis and treatment of the disease. They include the following:

• purulent synovitis
  
• panratrite - total inflammation of all joint structures
  
• process chronicity
  
• patient disability.

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