Synovitis of the hip joint

The most characteristic manifestation of synovitis is pain of varying severity, which may be accompanied by swelling, a local increase in temperature and limitation of movement in the joint.

Etiology

The etiology of synovitis is diverse. Synovitis can develop in response to cartilage damage, the appearance of loose intra-articular bodies, and instability.

Clinical picture

The most characteristic manifestation of synovitis is pain of varying severity, which may be accompanied by swelling, a local increase in temperature and limitation of movement in the joint. Painful jamming as a result of synovial villi getting trapped between the articular surfaces is much more common in the ankle than in other joints.

Diagnostics

Palpation over the affected joint area causes pain. Sometimes intra-articular effusion . The range of motion in the joint should be compared with the opposite side. It is necessary to take into account the angular deformation of the limb axis and its instability due to damage to the capsular-ligamentous apparatus as possible causes of pain.

Osteophytes can often be found on the anterior surface of the talus and/or the anterior edge of the tibia. In some cases, uneven contour of the talus, calcification or intra-articular bodies are determined. Often no significant deviations from the norm are detected on radiographs.

Anatomy

The synovium is located around joints and ligaments, providing them with protection. This occurs due to the release of a small amount of fluid (lubricating secretion), which reduces friction and provides shock absorption.

The exact cause of hip synovitis is unknown, but some theories include a history of trauma to the femur or a recent viral illness such as an upper respiratory tract infection, bronchitis, or otitis media.

One of the reasons for the development of inflammation of the hip joint is infection in the synovial fluid. This occurs against the background of any other infectious disease. In this case, fever, a significant increase in body temperature and general poor health are added to the classic symptoms. In this case, it is necessary to first deal with the source of infection.

Main reasons:

sports injury;
stretching;
blood diseases;
metabolic problems;
endocrine pathologies;
dystrophic joint pathology;
overweight;
allergy;
bruises.

Among the infectious pathogens that most often cause synovitis are pneumococci, streptococci, staphylococci, Koch's bacillus (tuberculosis) and STIs (sexually transmitted infections).

Causes of synovitis of the hip joint and its treatment

Synovitis of the hip joint is an inflammatory disease that affects the synovium and is accompanied by the accumulation of effusion in the joint capsule. This disease is especially common in boys under 10 years of age. In terms of prevalence, it ranks second, the first being synovitis of the knee joint.

Classification of synovitis

According to the method of origin it can be:

Causes of synovitis of the hip joint and its treatment: traumatic (most common) - develops with mechanical damage to the joint (fractures, dislocations, punctures, bruises);
Causes of synovitis of the hip joint and its treatment: infectious - detected when pathogenic microorganisms penetrate into the joint cavity;
Causes of synovitis of the hip joint and its treatmentreactive (a type of allergy) - occurs in response to the development of various diseases (tuberculosis, syphilis) or the accumulation of toxic substances in the body;
Causes of synovitis of the hip joint and its treatmenttransient (mainly diagnosed in children) - manifests itself as a result of increased loads on the hip joint or after viral diseases (influenza), manifests itself suddenly and develops rapidly.

Depending on the type of effusion, synovitis is divided into:

serous;
serous-purulent;
purulent.

The latter type is characterized by the accumulation of pus in the joint capsule and the appearance of weakness and fever. The cause of the disease can be a postpartum infection, bruise or injury, leading to the development of sepsis. Synovitis can occur in acute or chronic form, the latter develops with improper treatment or its absence.

Causes of the disease

Inflammatory processes can be provoked by:

injuries that violate the integrity of the synovial membrane;
allergic manifestations due to intoxication of the body;
disruptions in the functioning of the endocrine and nervous systems;
infections;
degenerative processes in joints;
ligament weakness;
hemophilia;
severe stress.

Symptoms of inflammation

Synovitis of the hip joint is usually accompanied by:

pain;
limitation or complete loss of mobility;
the appearance of effusion (fluid accumulation);
muscle spasms;
swelling and edema;
joint deformation;
redness of the skin;
local temperature rise.

Treatment of synovitis

For treatment to be successful, it must be comprehensive and focus on:

elimination of the causes of inflammation;
relief from symptoms of the disease;
restoring the functionality of the joint;
general strengthening of the body.

Therapy of inflammatory processes is carried out in several stages:

puncture - a needle is used to pierce the joint and remove synovial fluid;
immobilization - joint mobility is limited for 5-7 days using a special patella or pressure bandage, in some cases plaster splints or splints are installed;
drug treatment;
physiotherapy;
physiotherapy.

Several groups of drugs are used in the fight against synovitis:

non-steroidal anti-inflammatory drugs (ibuprofen, voltaren, indomethacin, diclofenac, movalis) – suppress the inflammatory process and relieve pain;
glucocorticosteroids (dexamethasone, Kenalog-40) – necessary for severe disease;
inhibitors of proteolytic enzymes (Gordox, Trasylol) – stop degenerative and necrotic processes;
antibiotics – prevent the development of secondary infection after puncture;
drugs that stimulate blood microcirculation (troxevasin, trental, nicotinic acid, ATP);
Dietary supplements (Collagen Ultra) – prevent the transformation of the disease into a chronic form;
vitamins – strengthen the immune system.

Nonsteroidal anti-inflammatory drugs are used both internally and topically in the form of creams and ointments. To increase the effectiveness of treatment, the patient is prescribed physiotherapeutic procedures and therapeutic exercises. If conservative therapy is unsuccessful, they resort to surgery, during which partial or complete removal of the synovial membrane is performed.

Preventive measures

To avoid the development of synovitis of the hip joint, you must:

Do regular moderate exercise;
avoid injuries and stress;
treat infectious diseases in a timely manner;
maintain the normal functioning of the nervous and endocrine systems.

Typology

In medicine, the following classification of synovitis is proposed:

infectious – there is infection with a pathogen;
traumatic – due to mechanical injury;
reactive – develops due to prolonged mechanical trauma, for example, at work (car mechanic, builder, athlete, etc.);
aseptic – for endocrine diseases (for example, diabetes), blood diseases (hemophilia) and metabolic disorders (gout);
allergic - allergens affect the synovial membrane when it has increased sensitivity.

To make a correct diagnosis, it is imperative to tell the doctor about all possible signs and sensations during the inflammatory process.

Diagnosis of fluid accumulation in the knee joint

If such symptoms occur, it is recommended to immediately consult a specialist. Fluid accumulation can be a symptom of serious medical conditions that should be diagnosed as early as possible.

At the first consultation, the specialist will palpate the knee joint and prescribe a series of instrumental examinations. Among them:

Puncture of synovial fluid;
Radiography;
Ultrasound examination;
Magnetic resonance imaging;
Arthroscopy.

Also during diagnosis, it is important to puncture the accumulated fluid. This will help determine if there is pus or other inclusions in the fluid.

Clinical examinations include a general blood and urine test.

Symptoms

The general clinical picture of the pathology consists of severe pain, weakness/poor health and local hyperthermia. The patient's body temperature may also rise to low-grade levels (37-37.5 °C). Often inflammation is accompanied by swelling and redness of the skin over the joint. The pain syndrome intensifies when leaning on the leg, moving it to the side and during palpation.

With an infectious etiology, the disease begins acutely, with an increase in body temperature and general malaise. Then bursting pain appears in the joints (at the site of suspected synovitis). Within a few hours, severe swelling, hyperthermia and local hyperemia develop. The patient feels a headache, an increase in general body temperature, and sometimes there are other signs of intoxication.

With non-infectious etiology, the pathology does not develop so quickly, but this will depend on the cause. The primary symptom complex is represented by pain when moving. After a couple of days, swelling, hyperthermia, hyperemia, joint deformation and increasing pain are added.

Treatment of synovitis of the wrist joint

If the pathology has a traumatic etiology, the patient is given local therapeutic treatment. The acute form requires observation and treatment in a hospital setting. Purulent synovitis is treated through surgery, including partial or complete excision of the synovial bursa.

Physiotherapy has proven itself well in the treatment of synovitis of the left or right wrist joint. At the Central Clinical Hospital of the Russian Academy of Sciences, as part of physiotherapeutic treatment, patients are prescribed magnetic therapy, laser or ultrasound exposure.

Diagnosis and treatment

Before making a diagnosis, a traumatologist must conduct a physical examination, interview, prescribe tests and diagnostics. Differential diagnosis may require X-ray examination and/or ultrasound. If an infectious etiology is suspected, it is necessary to undergo a biochemical and general blood test, urine test, and an antibiogram to determine sensitivity to antibiotics.

Treatment for hip synovitis includes simple home remedies such as rest, heat, and massage of the painful area. Avoid putting weight on the affected side until the pain goes away.

If the inflammatory process is mild, it is possible to carry out conservative treatment in the form of analgesics, NSAIDs, vitamin complexes and the application of warming ointments. For more severe development, injections with glucocorticosteroids are prescribed. A mandatory condition for treatment is bed rest. For rehabilitation, exercise therapy, massage and electrophoresis are prescribed (after the end of the acute period). In case of irreversible degenerative disorders, they resort to synovectomy - removal of part of the affected tissue.

When there is a large accumulation of fluid, arthrocentesis is used for diagnosis and treatment - puncture of the hip joint. During this procedure, an anesthetic is administered. With its help, the quantity, color, consistency and presence of impurities in the form of pus and blood are assessed. The liquid is sent for analysis to identify the infectious agent. The joint is washed and an anti-inflammatory drug is injected. After determining the cause of infection, the question of injecting an antibiotic or hormone into the joint is decided.

The success of treatment directly depends on how quickly the patient consulted a doctor, the severity of the lesion and the duration of therapy. With the correct response, complete recovery and restoration of joint function occurs. On average, this takes up to 10 days, taking into account at least 2 weeks of rehabilitation period.

Diseases and their causes

The accumulation of fluid in the joints and the primary causes of the anomaly lead to the development of various diseases:

Hemoarthrosis. Occurs after receiving mechanical damage. After this, blood enters the joint, accumulating in this area.
Synovitis. The disease is inflammatory in nature. During its development, the synovial membrane of the joint is affected, which ultimately leads to the patient experiencing a pronounced pain syndrome. There are several types of disease, differing in the initial cause of occurrence. Immune type, characterized by abundant secretion of interarticular fluid. Most often, it is a consequence of a strong reaction of the body to an allergen or a serious illness. Purulent inflammation can occur due to the entry of harmful microorganisms into the synovial bursa, causing chlamydia, gonorrhea, tuberculosis, dysentery and more. The aseptic type develops after injury, an infectious infection, or as a consequence of severe hypothermia. The liquid does not contain viruses or purulent microorganisms.
Arthrosis. One of the most common pathologies that occurs after severe mechanical injuries or natural age-related wear and tear of the joints. There are two stages of the disease. In the first, the amount of fluid near the joint decreases sharply and pain occurs, in the second, the fluid, on the contrary, accumulates in the affected area, due to which a tumor forms there.
Arthritis. This is a whole group of joint diseases that occur in an inflammatory form. The causes may be disorders of the immune system, regular stress on the same muscle group, mechanical damage, mental trauma, infectious diseases and allergic reactions. Most often it occurs in people who are overweight, exercise little, eat poorly, and live in regions with poor environmental conditions.
Bursitis. Occurs after infectious diseases or injury. Inflammatory processes develop in the synovial bursa, as a result of which fluid begins to flow into it. This disease can be considered an occupational one, since most often it develops in people who constantly experience stress on certain joints or muscle groups at work.

Also, the causes of the development of pathology in the joints and the occurrence of edema are often fractures of the articular bones.

Treatment of fluid accumulation due to a torn meniscus

If we take a closer look at the case when fluid accumulation is a symptom of a meniscal injury, then the treatment at the Elena Malysheva Medical Center will be as follows.

The meniscus is sutured using arthroscopic minimally invasive intervention. In this way, it will be possible to restore the integrity of the damaged area of tissue.

One of the stages of arthroscopic surgery is securing the fixing element to the cartilage. This will help protect your knee during exercise.

Based on statistics, 90% of meniscus suturing operations are successful, and thanks to minimally invasive intervention, the patient returns to his previous life in the shortest possible time.

Don't endure the pain! Diseases of the knee joints bring great discomfort and unbearable pain. Therefore, do not self-medicate, make an appointment at the Elena Malysheva Medical Center!