Symptoms

Patients suffer from pain, redness, overheating in various parts of the body. Theoretically, any tendon on any muscle in the body can be affected. Since not only the tendons (tendinitis) but also the muscles (myositis) and joints are often affected, patients complain of reduced strength, restricted movement and pain during physical activity. The symptoms can occur in an acute flare up for a short time and can also regress. However, they can also be chronic (long-term and permanent).

Synovialitis with rheumatism

The synovialis is the innermost layer of the joint capsule. It is a thin membrane that forms the synovial fluid (lubricant). In synovitis or synovialitis, this membrane is inflamed.

This inflammation manifests itself by a deposition of inflammatory cells, increased blood flow to the tissue, the vessel walls become leaky, allowing more fluid to pass through and water to accumulate. This leads to the development of a joint effusion. In the long term, when the inflammation becomes chronic, as is often the case with rheumatoid diseases, the cells of the synovia grow into the joint.

This leads to movement restrictions and pain for the patient. In many cases, the only way to treat this condition is arthroscopy (arthroscopy of the joint), in which the villi or the complete synovia are removed with a kind of electric shaver. The severity of the synovitis can be classified on the basis of a score (degree of classification to determine the severity of the disease).

This score assigns the classification low and high-grade. The removed villi are examined by the pathologist and evaluated according to certain criteria. Together with the rheumatologist or the orthopedist, the severity of the disease is then classified. If high-grade synovitis is present, a rheumatic disease is very likely.

Diagnosis

In the diagnosis of rheumatic diseases, the anamnesis (i.e. the patient’s medical history) comprises a very relevant part, since the attending physician can draw decisive conclusions regarding the possible disease from the description of the symptoms and the course of their symptoms, as well as, for example, diseases of blood relatives. Furthermore, the physical examination is important because it allows other causes of pain in the joint apparatus to be excluded or classified as unlikely.Blood testing makes it possible to find out whether inflammation markers (certain proteins in the blood that are elevated during inflammatory processes in the body) are present. In addition, antibodies and rheumatoid factors can be determined.

It is important to note that there are known antibodies that can be looked for. However, it is also possible that no antibodies are elevated, although a rheumatic disease is present. Or that antibodies are elevated although the patient is healthy.

Therefore, the evaluation of the antibody results can only work in conjunction with a good anamnesis, physical examination and further diagnostics. In addition to the above-mentioned examinations, X-rays are also used. Here changes in the joints, but also gross abnormalities in the soft tissue, such as calcifications, can be made visible. In addition, further information can be obtained with examinations such as computer tomography, MRI (magnetic resonance imaging) and also ultrasound (sonography).