Pathogenesis (development of disease)
In synovitis, an exudative inflammatory reaction (secretions) occurs in the stratum synoviale (inner layer of the joint cavity), and the synovial membrane swells. A granulocyte-rich joint effusion develops. Mobility is decreased due to worsening capsular stretching pain.
Etiology (causes)
Disease-related causes
- Allergic-related synovialitis
- Arthritis in:
- Lyme disease
- Psoriasis (psoriatic arthritis, PsA)
- Joint irritation after surgery
- Granulomatous arthropathies such as tuberculosis or sarcoidosis – systemic diseases that can lead to the formation of nodular changes even in joints
- Intraosseous ganglion – ganglion located in the bone.
- Crystal arthropathies such as gout and calcium pyrophosphate arthropathy.
- Loosening of artificial joints
- Meniscopathy – pathological change of the menisci.
- Bekhterev’s disease – chronic inflammatory disease of the spine, which can lead to joint stiffness (ankylosis) of the affected joints.
- Necrotizing fasciitis – foudroyant life-threatening infection of the skin, subcutis (subcutaneous tissue) and fascia with progressive gangrene; often involves patients with diabetes mellitus or other diseases that lead to circulatory disorders or reduced immune defenses.
- Postinfectious arthritis after viral infection such as rubella (rubella), parotitis epidemica (mumps) or HIV.
- Reactive arthritis (synonym: postinfectious arthritis / joint inflammation) – secondary disease after gastrointestinal (gastrointestinal tract concerning), urogenital (urinary and genital organs concerning) or pulmonary (lungs concerning) infections; refers to an arthritis, where pathogens in the joint (usually) can not be found (sterile synovitis).
- Reiter’s disease (synonyms: Reiter’s syndrome; Reiter’s disease; arthritis dysenterica; polyarthritis enterica; postenteritic arthritis; posturethritic arthritis; undifferentiated oligoarthritis; urethro-oculo-synovial syndrome; Fiessinger-Leroy syndrome; English Sexually acquired reactive arthritis (SARA)) – special form of a “reactive arthritis” (see above. ); secondary disease after gastrointestinal or urogenital infections, characterized by the symptoms of Reiter’s triad; seronegative spondyloarthropathy, which is triggered especially in HLA-B27 positive persons by an intestinal or urinary tract disease with bacteria (mostly chlamydia); Can manifest as arthritis (joint inflammation), conjunctivitis (conjunctivitis), urethritis (urethritis) and partly with typical skin changes.
- Rheumatoid arthritis – inflammatory multisystem disease, which usually manifests itself in the form of synovitis (synovitis).
- Storage diseases such as Fabry disease (synonyms: Fabry disease or Fabry-Anderson disease) – X-linked lysosomal storage disease due to a defect in the gene encoding the enzyme alpha-galactosidase A, leading to progressive accumulation of the sphingolipid globotriaosylceramide in cells; mean age of manifestation: 3-10 years; early symptoms: Intermittent burning pain, decreased or absent sweat production, and gastrointestinal problems; if left untreated, progressive nephropathy (kidney disease) with proteinuria (increased excretion of protein in urine) and progressive renal failure (kidney weakness) and hypertrophic cardiomyopathy (HCM; disease of the heart muscle characterized by thickening of the heart muscle walls).
- Tumors originating from synovial membrane such as hemangiomas, lipomas, or tenosynovial giant cell tumor.
