The synovial membrane is the part of the body that lines the inside of certain joints. It lines the joint capsule in the knee, ankle, wrist, elbow, hand, foot, and shoulder. When this membrane gets inflamed, it is called synovitis. Synovitis is often the result of repeated joint bleeds that are not treated early or correctly. With synovitis, the synovial membrane thickens and grows more blood vessels, causing even more bleeding into the joint. If you have synovitis, it means that your synovial membrane has become inflamed.
Symptoms
Because of the mass of inflammatory cells in rheumatoid arthritis, the joint appears swollen and feels puffy to the touch. The increased blood flow that is a feature of the inflammation makes the joint warm. The cells release enzymes into the joint space which causes further pain and irritation. If the process continues for years, the enzymes may gradually digest the cartilage and bone of the joint leading to chronic pain and degenerative changes.
- The joint remains swollen and "spongy" even after treatment.
- There is usually no pain or loss of motion unless there is an active bleed.
- There is an increased number of bleeds in the same joint.
Causes
The pain caused by synovitis can be a major problem in connection with other illnesses such as juvenile arthritis, lupus, and psoriatic arthritis. Synovitis can also be part of rheumatic fever, tuberculosis, injury, or gout. It is a defining characteristic of rheumatoid arthritis. In that disorder, the cells in the inflamed membrane attract other inflamed cells from all over the body, making the synovitis more and more painful. Sometimes it is not known what is causing the synovitis; a person may have had an injury that seemed minor at the time, or they may not recall an injury at all, but the fluid collects in response to the trauma and causes inflammation.
Synovitis can be distinguished from other joint disorders because it causes the area around the joint to appear swollen. It also feels puffy, and may even be warm to the touch. Enzymes are being released around the joint that, if left untreated may actually digest the healthy cartilage and bone of the joint, causing chronic pain and degeneration. Aside from the joint being red or swollen, there may also be stiffness, pain, and a popping feeling when you move the joint or put pressure on it.
Diagnosis
In addition to the clinical presentation the diagnosis may be helped by Synovial Fluid Analysis. This is a test that examines the lubricating fluid secreted by synovial membranes. The test is useful in the diagnosis of some types of arthritis. The test takes about half an hour and usually is done in a physician’s office or hospital. No special preparations are necessary. The skin over the joint is cleaned with an antiseptic. Usually, a local anesthetic is injected. Using a thin needle, the physician will withdraw a sample of fluid for analysis, including culture of the fluid if infection is a possible diagnosis, and examination for crystals to diagnose gout or pseudogout. If needed, medication can be injected into the joint space through this needle after the specimen is taken.
Treatment
Synovitis is usually treated with anti-inflammatory drugs. These could include aspirin or ibuprofen or corticosteroids. Ice is also useful to help reduce swelling. Fluid from around the knee can be drawn out, but that is a temporary solution done to ease the discomfort. More severe cases may require cortisone injection or surgical removal of the inflamed tissue. If there’s enough damage, especially to the knee, replacement surgery might be required. The treatment depends on what is causing the synovitis in the first place and how severe the symptoms are. In synovitis of the hip, the child should be checked by the doctor several times throughout the course of the attack, and then again six months later to ensure that there are no further problems.
So even if your rheumatoid arthritis is not troubling you, you may have still joints or soreness from time to time. Standard treatments for synovitis, such as anti-inflammatories and ice application, can help with this remission pain.
