Synovitis is a pathology in the presence of which an inflammatory process develops in the synovial membrane and an effusion forms. Most often, the lesion is called synovitis of the elbow joint. As a rule, the inflammatory process develops in only one elbow. Damage to both joints is extremely rare.
The reasons for the development of synovitis of the elbow joint can be quite a lot. The main ones include infection, injuries, allergic reactions, hormonal diseases, metabolic disorders. The main symptoms are severe malaise, an increase in the volume of the affected joint, the presence of pain, weakness. If the cause is an infection, then symptoms of intoxication are also added.
Synovitis classification
To date, several different types of synovitis of the elbow joint are distinguished, depending on how the disease progresses.
- Acute - pathology is accompanied by pain, the synovial membrane becomes thicker, hyperthermia is observed.
- Chronic synovitis of the elbow joint. In the articular capsule, changes in the fibrous nature are formed. Sometimes villi located on the synovial membrane may increase, which leads to the development of villous synovitis.
Due to the appearance of “rice bodies”, even more severe damage to the synovial membrane occurs. This form of pathology is extremely rare and occurs due to untimely, improper treatment of the acute form of synovitis. It can also be the result of a latent inflammatory process of a sluggish nature in the body.
Depending on the type of inflammatory process and the nature of the effusion, such a pathology as synovitis of the elbow joint can be serous, hemorrhagic, purulent and serous-fibrinous. Given the cause of the development of the disease, then such forms as infectious, allergic, aseptic synovitis are distinguished. In ICD-10, the synovitis of the elbow joint is coded M 65.9 and belongs to the group "Synovitis and unspecified tenosynovitis."
Types of disease
Synovitis has a huge number of species that differ in their characteristics, symptoms and course. We will consider the most common types of pathology:
- Pigmented villonodular synovitis.
- Reactive synovitis.
- Post-traumatic synovitis.
Pigment villonodular synovitis - PVA
In the presence of this type of disease, the synovia grows, it is stained with hemosiderin. Over time, villi, nodular masses, pannus begin to appear. Such a disease is rare and more common at a young age. PVA develops for a very long time, over time, joint swelling and pain begin to intensify. During periods of exacerbation, the temperature can rise dramatically, effusion appears, the shape of the affected joint changes.
Reactive synovitis
It occurs due to limitations in the joint due to severe inflammation in its cavity. A large amount of fluid begins to accumulate in the synovial membrane , dull pain is felt during the movements, the joint increases in size, changes shape, and movements are limited. Reactive synovitis has a secondary character and develops against the background of the underlying disease.
Because of this, treatment of synovitis of the elbow joint is primarily aimed at eliminating the causes of the underlying disease. Antibiotics, corticosteroids, immobilization are used for therapy, NSAIDs are taken, physiotherapy is also necessary.
Post-traumatic synovitis
This type of disease is the most common. It occurs as a natural reaction to intraarticular damage. Sometimes post-traumatic synovitis can be confused with infectious arthritis or hemarthrosis. If there is an acute form of pathology, then the joint begins to deform, very severe pain is observed. In the chronic form of post-traumatic synovitis, the pain is aching, dropsy of the joint is observed, and the elbow quickly gets tired.
More rare forms of synovitis
- Moderate synovitis. Inflammatory processes of any type can develop into the development of moderate synovitis, in which the symptoms will be clearly expressed.
- Minimal synovitis. It arises in the same way as moderate, and for its treatment it is sufficient to regularly use special pressure dressings.
- Suprapatellar synovitis. The fluid begins to accumulate in the area above the elbow, and the inflammatory process of the synovial membrane is also observed.
- Exudative synovitis. Its development occurs without any trauma, that is, it refers to the primary disease. As a rule, the cause is irritation of the inner surface of the articular bag due to the separation of the meniscus, damage to the cartilage, or if the joints are unstable.
- Recurrent synovitis. Pathology in most cases is accompanied by a chronic form of hydrarthrosis. In this case, the formation of hypotrophy of the synovial membrane occurs, fibrosis is observed. A complication may be the appearance of dropsy, which provokes violations of a degenerative-dystrophic nature.
Where is synovitis localized?
Pathology can develop in a variety of joints:
- In the ankle.
- Temporomandibular.
- In the knee, hip joint.
- In the elbow, wrist.
- In the shoulder joints.
- In the big toes and in the joints of the foot.
Symptoms of synovitis
Synovitis usually develops in only one joint. Very rarely, a disease affects several joints simultaneously.
The main symptoms of synovitis of the elbow joint:
- The joint becomes limited in movement, with a load there is severe pain.
- The shape of the joint is changing, severe swelling is manifested.
- General weakness, severe malaise.
- In the affected area, hypertension of the skin occurs, the skin becomes very hot.
The severity of signs will depend on the form of the disease, as well as on the individual characteristics of the human body.
Disease complications
In the presence of synovitis, a variety of complications can occur:
- Purulent arthritis - occurs due to the spread of purulent inflammatory process on the fibrous membrane of the joint capsule.
- Gonarthrosis - there is a defeat of hyaline cartilage. This type of arthrosis is the most common and can quietly develop for several years.
- Sepsis occurs in the absence of therapy or if the person’s immunity is very weak.
- Dropsy appears due to the large amount of fluid in the affected joint.
- The joint becomes too loose, and the ligaments are weak, which can lead to frequent dislocations, fractures, subluxations.
Diagnosis of the disease
The diagnosis can be made taking into account the existing symptoms. Diagnostic puncture and other studies are also mandatory. It is necessary not only to determine the presence of synovitis, but also to establish the cause of its development, which is sometimes very difficult.
A thorough examination will determine all the symptoms and treatment of synovitis of the elbow joint. If an aseptic form of pathology is suspected, then the doctor may prescribe arthroscopy, arthropneumography. In some cases, it is impossible to do without a study of a cytological nature, a biopsy of the synovial membrane. If there is a suspicion of an allergic form of synovitis, then it is mandatory to conduct allergic tests.
Synovitis Treatment
The main principles of therapy include puncture, immobilization. Sometimes even surgery or drainage may be necessary. If a purulent form of synovitis is observed, then the treatment takes place in the hospital of the surgical department, with the traumatic form, they are placed in the traumatological department, and all other patients are sent to the hospital that corresponds to the profile of the primary disease.
Treatment begins with a puncture of the affected joint. The needle penetrates the joint cavity, the right amount of fluid is collected, then antibiotics are introduced for prevention. Such therapy is painless, so anesthesia is not performed.
Regardless of the type of synovitis, immobilization is necessarily indicated. The affected joint is completely immobilized with a bandage, knee pad. Most patients are prescribed NSAIDs as an ointment, injection, or oral medication. Corticosteroids may be injected into the joint. As an addition, physiotherapy is performed.
Prevention of synovitis
As a prophylaxis, therapy of inflammatory diseases is used, as well as the earliest possible diagnosis of synovitis. It is also worth being extremely careful while doing the exercises. In the diet there must necessarily be products that contain vitamin C, D, gelatin, agar-agar, volatile.
Traditional medicine against synovitis
Traditional medicine can be used only after the permission of the attending physician. It is worth noting that folk remedies can only be an addition to the main therapy.
Tincture
Grind 100 grams of comfrey roots, fill them with half a liter of vodka. Insist the remedy for two weeks. The medicine is used 3 times a day for 1 teaspoon, regardless of the location of the disease, whether it is synovitis of the left elbow joint or shoulder.
Ointment
Twist in a meat grinder 200 grams of lard, mandatory salted. Mix with 250 grams of comfrey. Leave the ointment to infuse for a week, then the mixture can already be applied to the joint affected by synovitis. After application, a tight dressing must be applied.
Decoction
Take the same amount of grass mistletoe, thyme, St. John's wort, eucalyptus, tansy, valerian flowers, licorice, calendula, celandine, chopped roots of marshmallow and calamus. Each plant should be in small quantities - half a teaspoon. The broth is taken only after eating instead of tea. The course of treatment is only two months, regardless of localization (synovitis of the right elbow joint, fingers, shoulder joints, etc.).