Diagnosis | Synovitis of the wrist

Diagnosis

The diagnosis of synovitis is initially based on the medical history, i.e. the interview of the affected person by the doctor. In particular, chronic causes of synovitis should be investigated in detail. During the physical examination, movement restrictions and pain points can be recorded.

This is usually followed by an ultrasound examination of the wrist. In particular, an inflammatory thickening of the synovia can be assessed. But also chronic damage to ligaments, tendons, cartilage and bones can be detected by ultrasound. In order to distinguish synovitis from rheumatism, it is often useful to take a blood sample and determine the blood values in the laboratory.

Therapy

Acute therapy of synovitis is initially only symptom-related. The affected wrist should be relieved. Regular cooling of the wrist and raising the arm can also lead to an improvement in the symptoms.

In addition, anti-inflammatory drugs can be taken, which also have an analgesic effect. However, the taking of medication should be discussed with the doctor treating the patient. In acute synovitis, the disease can often be treated by these conservative measures.But especially in chronic synovitis of the wrist, surgery is usually the only way to completely cure the disease.

Excluded from this are people who suffer from synovitis due to other diseases. The most classic example is rheumatoid arthritis. The therapy of the underlying disease consists of a mixture of different components: medicinal therapy elements are painkillers, anti-rheumatic drugs and cortisone preparations.

In addition, synovitis caused by rheumatism can also be operated on. An alternative therapy is the irradiation of the wrists. Surgery is necessary especially if the synovialitis on the hand or wrist is chronic and cannot be treated satisfactorily by conservative treatment methods.

Synovialitis caused by an underlying disease may also require surgery. First of all, one tries to alleviate the symptoms of the wrist by treating the underlying disease. If this does not succeed sufficiently or if the complaints are strongly restrictive, an operation of the affected hand or wrist is recommended.

Surgery for synovitis of the wrist can usually be performed using a minimally invasive technique (keyhole technique). For this purpose, several very small incisions are made in the wrist, which allow various instruments to access the inside of the wrist capsule. A camera and instruments are inserted through these incisions.

The operation can be performed under local or general anesthesia. As a rule, the entire synovium is removed after opening the joint capsule. In order to minimize bleeding and the influence of wound secretions, a drainage system is often inserted through which the fluids can drain off.

The small incisions are then sutured and the wrist bandaged. Irradiation offers a good alternative to hand surgery in cases of synovitis of the wrist. In the so-called radiosynoviorthesis, the wrists are irradiated.

This is intended to stop the inflammatory process at the synovia. So far, irradiation has proven to be a good therapeutic option, especially for rheumatoid arthritis. However, radiation therapy should be avoided if possible in pregnant and nursing mothers as well as in children and adolescents.