Associated symptoms

Symptoms of inflammation of the synovial membrane are typical signs of inflammation: redness, swelling, overheating and pain. Inflammation of the synovial membrane results in a proliferation of the epithelial cells of the mucosa. As a result, more synovial fluid is produced by these cells.

This leads to increasing swelling and constriction of adjacent structures, which is associated with severe pain. The inflammation causes the immune system‘s defense cells to 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.

In most cases, the pain occurs when moving the affected joint and joint stiffness may also occur. Occupational groups with kneeling activities, such as tilers or cleaners, have a greatly increased risk of inflammation of the synovial membrane of the knee and pronounced growths of the membrana synovialis of the knee joint may occur. These may have developed over a long period of time and be accompanied by progressive destruction of the cartilage and bone. After long periods of stress or strenuous physical work, an inflammation of the joint mucosa usually manifests itself through increasingly severe pain and restriction of the range of motion of the affected joint. What could also interest you: Joint pain

Diagnosis

To diagnose an inflammation of the synovial membrane, other inflammatory diseases such as arthritis must be excluded. In most cases, however, several diseases occur simultaneously in old age, making it difficult to differentiate between them and synovitis may remain 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. For the development of synovitis, a joint puncture can be performed and a tissue sample of the joint capsule can be taken.

This can be evaluated microscopically by a pathologist and the severity of the condition can be determined. In the beginning, the affected joint should be immobilized. Elevation and cooling are also recommended measures for the treatment of inflammation of the joint mucosa.

Regular cooling causes the swelling of the inflamed area to subside, as the cold causes the vessels to constrict and the increased blood flow is reduced. Furthermore, anti-inflammatory and pain-relieving medication is recommended. If the symptoms do not improve despite immobilization, elevation and cooling, a doctor should be consulted urgently.

If other diseases, such as arthritis, occur in addition to inflammation of the synovial membrane, they should also be treated. If a pronounced joint effusion is observed, it should be relieved by puncturing the joint space. The removed fluid can be examined.

Depending on the results, it may be necessary to initiate antibiotic therapy. In case of severe inflammation or recurrent synovitis, the patient may be advised to undergo surgery, also known as arthroscopy (joint endoscopy). This operation is usually performed in a minimally invasive manner.

Small skin incisions are made under anesthesia, through which the necessary equipment, sometimes a camera, is inserted into the joint space. Depending on the extent of the operation, more or less parts of the joint mucosa are removed. It may be sufficient to remove the proliferation of the mucosa to achieve a reduction in the inflammatory process.

In cases of pronounced synovialitis, it may be necessary to remove the entire inner joint mucosa (synovectomy). A synovectomy is an operation in which the inner joint mucosa is removed. It is mostly used in cases of very pronounced or recurrent synovitis, in order to achieve healing of an inflammation of the joint mucosa.

As the inflamed tissue is removed, further destruction of the joint and adjacent tissue should be prevented and the patient’s symptoms alleviated. The operation can be performed open, i.e. with opening of the joint space, or minimally invasive with a few small skin incisions. In most cases a synovectomy is performed to treat rheumatoid arthritis.

The radiosynoviorthesis is used to treat chronic inflammatory joint diseases. Examples are rheumatoid arthritis, psoriatic arthritis or activated arthrosis. In this treatment, beta-emitters are introduced into the joint space. Their radioactivity inhibits the growth of the epithelial cells of the membrana synovialis and leads to scarring of the mucosa. The aim of a radiosynoviorthesis is to prevent further destruction of the joint and to reduce the patient’s symptoms.