The knees belong to the largest joints in a person, and they provide a very important function, namely, they help a person to move normally. However, at the same time they are subject to significant loads, since during the day they have to withstand the weight of a person.
The design of the knee joint is quite complicated, and any part of it can be periodically injured and hurt. With the course of inflammation, synovitis of the knee is formed. Gradually, the joint begins to suffer greatly and eventually ceases to function normally. That is why if there is pain in the knee, you should immediately consult a doctor for diagnosis and treatment.
Disease feature
Synovitis of the knee is a pathological process characterized by the occurrence of inflammation in the synovial membrane. In this case, fluid gradually accumulates in the joint bag.
Usually the synovial membrane runs completely throughout the joint, and there are many capillaries that provide power to this joint. The synovial membrane is responsible for the proper nutrition of the cartilage tissue, secreting fluid.
With the course of inflammation, the process of secretion of articular 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 types
Synovitis of the knee is divided into infectious and aseptic. The first type of disease occurs as a result of penetration of pathogens into the synovial membrane. Bacteria can enter the joint with blood flow or directly into the wound.
Aseptic synovitis of the knee joint is formed as a result of injuries and various disorders in the body, for example, with 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, in particular, such as arthritis. Secondary occurs mainly after injury.
A similar pathology can form with absolutely any injury to the knee, as well as after surgery. This can lead to the fact that the shell actively produces fluid, it can accumulate in the joint bags, causing synovitis.
Stages of the disease
Synovitis of the knee joint is divided into acute and chronic stages. Acute is characterized by rapid course, a pronounced clinical picture. At the same time, there is a significant increase in the size of the affected knee joint, pain syndrome, as well as 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 contents acting as a lubricant. Due to this, the articular parts glide easily without being subjected 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.
An excessive amount of such exudate is a kind of reaction to an adverse 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 articular cavity, forming an infiltrate.
Leaking inflammation can be stopped only by medical or surgical methods. In some cases, folk remedies give a good result. Retropatellar bursitis or synovitis of the knee joint can occur for reasons such as:
- inflammatory diseases of the musculoskeletal system;
- endocrine pathologies;
- rheumatism;
- diabetes;
- menopause;
- gout;
- eczema;
- injuries
- bruises;
- burns;
- autoimmune diseases.
Common causes of infectious synovitis are staphylococci and streptococci. In order to avoid infection and the development of dangerous complications, at the first signs of the disease, you should consult a doctor.
The main symptoms
The main cause of the disease does not affect the development of symptoms of knee synovitis, with the exception of only an acute infectious process. They are determined by the intensity of the 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 increase in symptoms. First of all, there is pain, which has certain features, namely:
- not limited to just one point;
- with acute synovitis, the knee hurts very much;
- there is an increase in painful manifestations in the morning and weakening in the evening;
- slightly subsides at rest.
A slight period of time after the onset of intense pain in the affected joint may cause a slight swelling. It is impossible to bend and unbend the affected joint completely, since such an action only begins to significantly increase pain. Therefore, active movements in the joint are somewhat limited.
If a person suffers from acute infectious synovitis, then local symptoms may be accompanied by signs of intoxication, headache, decreased appetite, fever, severe weakness. If treatment is not done in a timely manner, this can provoke the formation of phlegmon of the knee joint.
Compared with 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 capsule joints become thinner. As a result:
- pains begin to intensify;
- mobility of the knee joint is limited;
- joint instability is observed.
For a chronic form, a febrile symptom is unusual. During the period of exacerbation, the temperature may increase slightly. With proper treatment, a person has only signs of moderate, which have almost no effect on his quality of life.
Diagnostics
Synovitis of the right knee is most common, and this disease requires a thorough examination. The doctor cannot make a diagnosis only on the basis of patient complaints, since the symptomatology of the disease is not specific. This may indicate the presence of many diseases. Diagnostic measures include:
- history taking;
- examination by a specialist;
- laboratory research;
- instrumental techniques.
When diagnosing synovitis of the right knee, the joint is visually inspected, palpation is performed, as well as special testing. Laboratory studies include immunological, biochemical and bacterial analysis. In addition, synovial fluid and urine are examined.
From instrumental techniques, tomography, radiography, ultrasound and arthroscopy are indicated. 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 prescribed. In addition, inspection by specialized specialists may be required.
Treatment feature
Treatment of synovitis of the knee is carried out depending on the severity of the pathology. Of great importance is the cause of the disease. At the initial stage, doctors mainly prescribe conservative therapy, in particular, immobilizing the knee with an orthosis or plaster and taking medications. If there is a lot of joint fluid, there is blood or pus in it, then a medical puncture is required. Chronic, chronic knee synovitis (4 years, for example), which periodically bothers, is treated by surgical intervention.
Puncture is performed in order to cleanse the joint cavity from effusion and take it for histological analysis, and then determine the cause of the disease and the nature of the inflammation. The procedure is carried out using local anesthesia, so the patient does not feel absolutely no discomfort.
The doctor pierces the knee with a thin long needle and pumps the contents out of it. Then the affected joint is washed with disinfectants. In addition, if necessary, an antibacterial agent is administered. To achieve a better result, it is necessary to repeat the procedure 3-4 times.
To eliminate the unpleasant symptoms of knee synovitis, treatment is carried out by the use of medications. They will help eliminate inflammation, swelling and soreness. Depending on the type of disease, such drugs as:
- painkillers;
- anti-inflammatory;
- antibiotics
- corticosteroids;
- medicines to improve blood circulation;
- drugs to reduce the activity of enzymes.
The immobilization of the limb is also shown to prevent the destruction of the joint during movement. For this, a plaster cast and various 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, which helps to eliminate pain and inflammation in the synovial membrane, as well as normalize the blood circulation. With synovitis, electrophoresis with medications, magnetotherapy, and laser treatment are often prescribed.
You can apply warm compresses for synovitis of the knee, however, if the disease is non-infectious in nature. In the presence of infection, heating is strictly prohibited. After eliminating inflammation and pain, the patient is selected exercise therapy techniques and prescribed therapeutic massage to restore normal joint function.
Exercise helps to normalize the blood circulation, improve motor activity and further strengthen muscles. It is worth remembering that after immobilization the joint is greatly weakened, so it is not worth overloading it too much.
Drug 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 the disease cannot be completely cured. These include such as:
- arthritis;
- gout;
- osteoarthrosis.
For each individual form of the disease, its own treatment regimens have been developed that allow returning the full functioning of the joint.
For the treatment of acute traumatic form of synovitis, drugs such as:
- anti-inflammatory drugs ("Ibuprofen", "Diclofenac", "Nimesulide");
- proton ulcer inhibitors (omeprazole, rabeprazole);
- antibacterial agents.
The drugs are used in tablet form or as an injection. With very severe pain, injections are injected directly into the affected joint, as this allows you to quickly eliminate pain and inflammation. With proper therapy, unpleasant symptoms disappear after about 5-11 days. In addition, with severe injury, surgery and subsequent stretching of the leg may be required.
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, articular capsule, cartilage. That is why it is important to timely puncture the knee joint with the introduction of disinfectants. After this, macrolides or penicillin antibiotics are prescribed. They have a high degree of effectiveness and help minimize side effects. It is recommended to use such drugs as Erythromycin, Amoxiclav, Azithromycin, Ampicillin.
For the treatment of rheumatoid or psoriatic synovitis of the left knee (as well as the right), it is necessary to treat the underlying disease. For this, complex therapy is used with the use of such drugs as:
- anti-inflammatory drugs along with Omeprazole;
- chondroprotectors;
- glucocorticoids.
In order to effectively eliminate the symptoms of knee synovitis, treatment should be carried out under the strict supervision of a rheumatologist. Self-treatment for this form of the disease is unacceptable.
Tuberculous synovitis is a special form that develops against the background of pulmonary tuberculosis. Therapy is carried out in a specialized clinic. After 9 months of treatment, the symptoms of the disease can be completely eliminated.
Folk techniques
Treatment of synovitis of the knee with folk remedies is used quite often, since 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, oiled 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 soreness, therefore it is used in combination with other methods. Timely treatment will allow you to quickly get rid of existing signs and prevent disability.
Many are interested in whether it is possible to warm the knee with synovitis and how to do it right. For this, it is necessary to apply only dry heat, and also use a compress with paraffin. This allows you to quickly and more effectively eliminate the pain. Warming the knee with synovitis is strictly prohibited in case of an infectious lesion, as this will lead to its progression and the development of an abscess.
Salt compresses help to cope with inflammation and soreness well. For their preparation, sea salt is used, which must be diluted in water and moistened with a clean cloth in the prepared solution, then squeezed it a little and applied to the affected area. All these techniques can be applied when the integrity of the skin at the site of damage is not broken.
Surgical intervention
Some patients are interested in why knee synovitis does not pass. 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 its complete excision is performed. Often the operation is performed using an arthroscope. This type of surgical intervention is considered the most sparing.
Removing a specific area of the synovial membrane is completely harmless, since it is quickly restored from the remaining area. When excising the entire membrane, the risk of complications increases, and patients are at risk of developing arthrosis and arthritis.
Recovery period
How to treat knee synovitis can only be determined by a doctor, however, regardless of the methods used, a rehabilitation period is required. For speedy recovery, physiotherapy and exercise therapy are prescribed. Therapeutic exercises help to improve blood circulation and strengthen muscles.
To do this, you need to perform stretching and relaxing exercises. Gradually increasing the amplitude of movements, doing leg swings with increasing effort and constant tension. The rehabilitation period can be carried out on the third or fourth postoperative day using physiotherapeutic techniques. Patients are prescribed:
- magnetotherapy;
- electrophoresis;
- phonophoresis;
- heat therapy;
- mud therapy;
- UHF
Magnetotherapy helps to accelerate tissue repair, reducing swelling, affecting the body with a static field. The course of therapy is 10 days. With electrophoresis, the pathological process is affected by constant electric impulses, which contribute to the rapid penetration of medications to damaged tissues. This allows you to dissolve the fibrin strands and stop the process of degeneration of the synovial membrane. The course of therapy is 10 days.
Phonophoresis involves ultrasound in combination with the introduction of medications, which helps reduce inflammation and eliminate swelling. The doctor selects the duration of treatment individually. After eliminating the signs of acute inflammation, UHF is required. A similar technique is based on the effect 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, there is a cessation of the production of lubricating fluid, leaching of cartilage and the formation of osteophytes. This provokes problems with movement and support function.
Damage to the knee joints changes posture and gait. When moving, a person does not try to lean too much on the affected limb. Due to spliced components, the leg cannot function fully. A person moves with a cane or crutches. The knee area changes, it thickens in size.
Complications of this disease are very serious, especially with a purulent form. In this case, arthrosis or arthritis begins to develop rapidly. Infection can penetrate into the periarticular tissues, which leads to the development of fistulas and purulent abscesses. Pathogens can enter the systemic circulation, gradually turning into sepsis. A septic complication is fatal.
In the chronic form of the disease, secondary arthrosis can occur, as well as many other pathological changes. Dangerous consequences can only be avoided with timely treatment and medical advice. When treating knee synovitis, the reviews are mostly positive, since with timely treatment, very good results can be achieved.
Prophylaxis
It is quite possible to prevent the occurrence of synovitis of the knee, the most important thing is to monitor your health and protect yourself from injury. To avoid inflammation, the following recommendations should be observed:
- timely treat inflammatory processes;
- in case of a knee injury, consult a doctor immediately;
- when doing sports you need to wear knee pads;
- a bandage should be worn during hard work.
Of great importance is human nutrition, as it must be balanced and useful. It is necessary to comprehensively strengthen the immune system, consuming many vitamins. It is not recommended to overeat, since the appearance of excess weight adversely affects the condition of the knees.
The prognosis of the disease largely depends on the cause, especially the course of the pathology, as well as the conduct of therapy. That is why you need not to delay a visit to the doctor, since timely therapy increases the chances of a successful recovery.