Synovitis of the shoulder joint – concomitant inflammation in trauma, infection or metabolic disorders. Symptoms have different strengths of manifestation depending on the nature of the origin of the pathogen. Pain, swelling with accumulation of fluid in the shoulder joint, limitation of motor activity can be treated with medication, physiotherapy and rest for the patient’s shoulder. Inflammation of the inner shell is preceded by trauma, diseases of various etiologies or disturbances in the course of the biochemical processes of the body. In most cases, treatment with a conservative method leads to a lasting positive result.
The loosest joint of the human body plays an important role for normal functioning. The movable connection of the humerus with the scapula allows free movement of the hand. Violation of functionality adversely affects the quality of human life.
Synovitis is an inflammatory process that affects the synovial membrane of the shoulder joint. A pathological condition develops due to irritation of the upper layer of the inner shell, consisting of many villi.
The main objective of the membrane is the production of synovial fluid for transporting nutrients and oxygen to tissues. An inflammatory reaction violates the articulation trophism and contributes to the filling of the articular bag with fluid that the synovial membrane does not have time to absorb back.
The provoking factors that contribute to the introduction of the stimulus include:
- damage to the shoulder joint after injury;
- infection penetrating an open wound with gunshot wounds or open wounds;
- damage to the articular capsule by microorganisms after the infectious pathologies suffered through the blood or lymph vessels;
- complication after inflammatory processes in the cartilage;
- violation of the synthesis of hormones;
- specific aggression of immunity in relation to your body.
Synovitis of the shoulder joint can occur acutely or chronically. The clinic of manifestations varies significantly depending on the pathogen and previous conditions. The main symptoms that remain unchanged at any origin of the pathology:
- pain syndrome;
- filling the capsule cavity with exudate;
- swelling and deformation;
- sharp restriction of movements of the upper limb.
Aseptic and infectious acute course of the disease begins suddenly and is manifested by vivid symptoms. The patient feels a piercing pain in the shoulder, proceeding against the background of swelling. The skin above the joint turns red and hot upon palpation.
Aseptic synovitis is accompanied by an accumulation of serous effusion and does not have an infectious origin. In this type of disease, the signs of the disease are muffled: the pain is moderate, the motor ability is preserved with some restrictions, the joint swells slightly.
With the introduction of a pathogenic microbe of purulent infection, synovitis becomes violent. Throbbing pain, accompanied by symptoms of general intoxication, causes suffering to the patient. The shoulder joint is deformed due to severe swelling and takes the form of a dense ball, this occurs when the elastic membrane of the joint is stretched with exudate.
The skin changes a healthy color to a crimson hue, any touch to a diseased joint leads to the appearance of severe soreness. The patient’s body temperature rises, nausea and chills appear. A weakened state causes apathy and a bad mood.
The acute form is successfully treated when the exact cause is identified, the synovial membrane is completely restored and does not undergo morphological changes.
A prolonged course of inflammation with synovitis causes minor aching in nature. The shoulder joint does not undergo significant external changes, when palpating it feels a slight soreness, when pressing on the joint capsule, resistance is felt, informing about the presence of effusion.
The nature of the exudate in chronic brachial synovitis is serous with a protein component. Over time, fibrin forms dense clusters that move freely in the cavity. The inflamed villi of the synovial membrane thicken, the modified components come off and form foreign bodies.
The pathological process develops slowly, gradually causing degenerative-dystrophic changes in the cartilage and bone tissue. With a protracted process that lasts for years, the shoulder undergoes severe deformation due to the abundant degeneration of a significant part of the synovial membrane.
Determining the cause of inflammation and confirming the diagnosis is carried out by a medical specialist when contacting a medical institution. The collection of exudate during the puncture is sent for bacteriological examination to determine the type of pathogen.
X-ray examination and ultrasound of the shoulder joint will warn of the development of dystrophic changes. In some cases, a synovial biopsy is prescribed. Arthroscopy of the inside of the joint capsule examines the shoulder using special equipment.
If you suspect the presence of an allergic factor or a malfunction in metabolic processes, additional consultation of narrow specialists is appointed: an endocrinologist, a rheumatologist, an allergist, an immunologist.
Therapeutic measures begin with rest of the shoulder joint. For this, a kerchief bandage is used, which unloads the shoulder, but leaves it movable. To provide more rigid immobilization, an orthosis according to the Deso bandage is prescribed.
Lack of load and compliance with the orthopedic regimen will ease the condition and contribute to the speedy return of hand functionality. The accumulated fluid is pumped out during a puncture. A less traumatic procedure, carried out using a thin needle, serves not only to remove exudate, but also for therapeutic washing of the bag.
Prescribing medications is part of the conservative treatment of synovitis of the shoulder joint. Only a doctor can prescribe drugs. Pharmacological groups for getting rid of shoulder pathology:
- Antibacterial agents are indicated to eliminate the infectious process and get rid of the pathogen. Antibiotics prescribed for synovitis – Azaran, Ificef, Vancomycin.
- Nonsteroidal anti-inflammatory drugs relieve inflammation and pain – Flurbiprofen, Piroxicam, Naproxen, can be used in the form of an ointment for local anesthesia.
- Corticosteroid hormones (Prednisone, Diprospan, Dexamethasone) are intended against the progression of inflammatory reactions, as a decongestant and anti-allergenic.
- Chondroprotectors (Alflutop, Noltrex, Structum) stop the destruction and repair damaged tissue.
Among the auxiliary methods, phonophoresis with drugs for synovitis is distinguished. Deep penetration of the drug enhances the therapeutic effect of traditional medicine. The impact of high frequency currents on the sore shoulder relieves inflammation and improves blood circulation.
Magnetotherapy is carried out during the period of subsidence of acute symptoms. Exposure to electromagnetic current is carried out to restore the motor ability of the upper limb, stopping residual reactions after inflammation.
Preventing the inflammatory process is much easier than treating synovitis of the shoulder joint. Proper nutrition, which contributes to the constant supply of minerals and trace elements for the normal functioning of the shoulder, will preserve the health and mobility of the shoulder for a long time.
Treatment of chronic foci of infection will eliminate the presence of bacteria inside the shoulder. Routine therapeutic support is important for normalizing the function of internal secretion organs. Turning to an orthopedist at the first sign of discomfort in the shoulder promotes early diagnosis and a complete cure for the shoulder joint.
Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.
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