Inflammation of the synovial membrane

definition

An inflammation of the joint mucous membrane, which is also called synovitis, is an inflammation of the inner coating of a joint, the synovial membrane. The synovial membrane produces the synovial fluid, which on the one hand acts as a shock absorber in the joint and on the other hand supplies the joint cartilage with nutrients.
In the event of inflammation, which can be acute or chronic, the synovial membrane can proliferate into the joint space and into the articular cartilage and destroy it. More joint fluid is formed and inflammatory cells of the immune system are activated and migrate. In the case of severe inflammation, ligaments or tendons can be injured and the entire joint can be destroyed.

causes

Inflammation of the synovial membrane can occur due to various causes. Bacterial or viral infections and the body's reaction to the foreign body can lead to severe inflammation of the joint space.Permanent overstimulation of the joint, for example in athletes, or constant pressure or shock loads with constant movement sequences at work also increase the risk of inflammation. Due to age-related wear and tear on the joints, which can be associated with degenerative diseases such as osteoarthritis, synovitis is not uncommon.

In the case of severe osteoarthritis of the joint, in which the cartilage is destroyed, rubbing of the joint surfaces and detached cartilage particles can lead to inflammation of the synovial membrane. Severe violence or trauma to a joint can also lead to inflammatory processes. Synovitis can develop due to autoimmune diseases in which the body falsely defends itself against the body's own substances. Examples of autoimmune diseases that can lead to synovial inflammation are rheumatoid arthritis or psoriatic arthritis.

Metabolic diseases such as gout, where there is too much uric acid in the body, can also cause inflammation in various joints. In this metabolic disease, crystals form in the joint due to excess uric acid, which activates the immune system and leads to a defense reaction and inflammation. Allergic reactions can also be the cause of synovitis.

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arthrosis

Osteoarthritis is a degenerative joint disease that is associated with joint wear. There is an increasing age-dependent cartilage wear. Rubbing the joint surfaces and loosened cartilage particles in the joint space can irritate the joint mucosa and thus cause synovitis. The overgrowth of the synovial membrane and the resulting increased formation of synovial fluid are responsible for the resulting joint effusion.

Read more on this topic at: Diagnosis of osteoarthritis

Concomitant symptoms

Symptoms of synovial inflammation are typical signs of inflammation: redness, swelling, overheating and pain. When the synovial membrane becomes inflamed, the epithelial cells of the mucous membrane overgrowth. As a result, more synovial fluid is produced by these cells. This leads to an increasing swelling and narrowing of adjacent structures, which is associated with severe pain. Due to the inflammation present, defense cells of the immune system migrate into the joint space and release enzymes and inflammatory substances. Increased blood flow to the inflamed synovial membrane, which can be observed in synovitis, also explains the typical signs of inflammation mentioned above. The pain usually occurs when moving the affected joint and joint stiffness can also occur.
In professional groups with kneeling activities, such as tiling or cleaning staff, the risk of synovial inflammation of the knee is greatly increased and pronounced growths of the synovial membrane of the knee joint can occur. These can have developed over a long period of time and are associated with progressive destruction of the cartilage and bone. After long exertion or strenuous physical work, inflammation of the synovial membrane usually occurs as the pain increases and the range of motion of the affected joint is restricted.

What might also interest you: Joint pain

diagnosis

To diagnose synovitis, other inflammatory diseases such as arthritis must be ruled out. Usually, however, several diseases occur at the same time in old age, which makes it difficult to differentiate and synovitis can go undetected. If symptoms such as pain, swelling, redness and overheating occur in a joint, an ultrasound examination is usually used to confirm the suspected diagnosis. To develop synovitis, a joint puncture can be performed and a tissue sample can be taken from the joint capsule. This can be evaluated microscopically by a pathologist and the severity of the severity can be determined.

Treatment / therapy

Initially, the affected joint should be immobilized. Elevation and cooling are also recommended measures for treating synovial inflammation. Regular cooling causes the inflamed area to swell, as the cold constricts the vessels and reduces the increased blood flow. Anti-inflammatory and analgesic medications are also recommended.
If symptoms do not improve despite immobilization, elevation and cooling, a doctor should be consulted urgently. If there are other diseases besides the synovitis, such as arthritis, these should also be treated. If a pronounced joint effusion can be observed, this should be relieved with a puncture of the joint space. The removed fluid can be examined. Depending on the result, it may be necessary to initiate antibiotic therapy.

In the case of severe inflammation or recurring synovitis, the patient may be advised to undergo an operation, also known as arthroscopy. This operation is usually performed in a minimally invasive manner. Under anesthesia, small skin incisions are made through which the necessary equipment, sometimes a camera, is inserted into the joint space. Depending on the severity, more or less portions of the synovial membrane are removed. It may be enough to remove the overgrowth of the mucous membrane to bring about a decrease in the inflammatory process. With pronounced synovitis it may be necessary to remove the entire inner joint mucosa (synovectomy).

Synovectomy

A synovectomy is an operation that removes the lining of the synovial membrane. It is mostly used in severe or recurring synovitis in order to heal inflammation of the synovial membrane. As the inflamed tissue is removed, further destruction of the joint and the adjacent tissue should be prevented and the patient's discomfort should be alleviated. The operation can be performed openly, i.e. with opening of the joint space, or minimally invasive with a few small skin incisions. A synovectomy is usually performed to treat rheumatoid arthritis.

Radiosynoviorthesis

The radiosynoviorthesis is used to treat chronic inflammatory joint diseases. Examples of this are rheumatoid arthritis, psoriatic arthritis or activated osteoarthritis. During this treatment, beta emitters are inserted into the joint space, which, through their radioactivity, inhibit the growth of the epithelial cells of the synovial membrane and lead to scarring of the mucous membrane. The aim of a radiosynoviorthesis is to prevent further destruction of the joint and to reduce the patient's discomfort.

Duration

A distinction is made between acute and chronic joint inflammation. In acute inflammation, discomfort occurs due to trauma or overuse of the joint. These occur over a shorter period of time than chronic synovitis.
Age-related wear and tear on the joints or other diseases such as rheumatoid arthritis play a decisive role in chronic synovitis. Repetitive movements, for example at work, can also develop inflammation over a long period of time. Usually the symptoms get worse over time without any improvement.

Joint mucosal inflammation in the knee

Joint mucous membrane inflammation in the knee usually occurs in professional groups with kneeling activities, such as tiling or cleaning staff, as the risk is greatly increased due to the constant constant stress. The increased stress and pressure exerted on the knee cause severe irritation. Frequent causes are also traumas that affect the knee and lead to inflammation.

Read more on this topic at: Knee Pain - What Do I Have?

Inflammation of the synovial membrane in the shoulder

As in other joints, there is a joint capsule in the shoulder that can be affected by inflammation. Since the shoulder is constantly in motion in everyday life, inflammatory processes can often occur here too. Trauma can also cause synovitis in the shoulder joint. In athletes who perform repeated throwing movements, the risk of joint mucosal inflammation of the shoulder is increased due to the constant constant movement.

Read more on this topic at: Shoulder pain

Inflammation of the joint lining in the hip

An inflammation of the joint mucous membranes in the hip can occur in the course of life for a variety of causes. Since our hips are exposed to great stress in everyday life, inflammations there are not uncommon. Usually, in old age, several degenerative diseases occur at the same time due to wear on the joints, for example arthrosis, which can be the cause of synovitis and should also be treated.

Read more on this topic at: Hip pain

Inflammation of the synovial membrane on the wrist

Synovitis of the wrist is common in patients with rheumatism. Since this disease is associated with arthritis of the finger joints, inflammation of the synovial membrane usually also occurs. The joints swell painfully due to the growths of the synovial membrane. In rheumatoid arthritis, it can develop in the wrist Caput ulnae syndrome cause excessive swelling and pain when extending the wrist.

Read more on this topic at: Wrist pain

Inflammation of the synovial membrane in the ankle

Synovitis in the ankle is usually caused by accidents or trauma. Most of these injuries occur during sports. As with other synovial inflammations, pain, swelling and reddening of the joint space occur. The affected joint should be elevated and cooled, and pain reliever or anti-inflammatory drugs may be taken if necessary.

Read more on this topic at: Pain in the ankle