What is the Synovium?
The synovium is the protective
membrane that covers all the bones, tendons, and cartilage
in your hip. The synovial fluid is the lubricating fluid
within the joint that helps the joint move smoothly.
Synovitis occurs when the synovial membrane becomes
irritated or inflamed. The synovium swells and produces
extra fluid as an attempt to protect the joint from
damage. Particularly common in children ages three to
ten is a condition called transient synovitis that lasts
from ten days to a few weeks. It is the most common
type of hip pain in children.
Traumatic and repeated injuries commonly
cause synovitis. It usually accompanies an underlying
joint injury that has chipped or roughened any of the
surfaces in your hip. Joint diseases, especially rheumatoid
arthritis and gout, can also cause synovitis. Transient
synovitis in children may be caused by an allergic reaction
to an infection somewhere in the body. You are most
at risk of suffering synovitis in contact sports like
football. The risk of synovitis also increases during
all sports and activities after repeated hip injuries
of any kind.
If synovitis is left untreated, your
hip pain may continue to worsen, which can make movement
increasingly difficult. Trying to ignore hip pain and
swelling may result in a more serious, underlying condition
going undiagnosed. Synovitis itself usually does not
put you at risk of any dangerous complications, and
physicians generally suggest healing with anti-inflammatory
medication. If pain and swelling do not go away, a corticosteroid
injection may be necessary.
There are usuallly three parts to
an orthopedic evaluation: mediccal history, physical
examination, and tests your physician may order.
Your physician may ask you about the
following information to help make the diagnosis:
Your age and history of other medical conditions.
nature of your pain – when it began; how long
it lasts; its location and severity; whether it radiates;
and any factors, like running or climbing stairs, that
relieve or increase the pain.
physical and athletic goals – information that
will help determine what treatment might be best for
you in achieving those goals.
you have fever, chills, weight loss, or other symptoms
The key to diagnosing synovitis is
finding the underlying cause. While asking you questions
to pinpoint your pain, physicians will also test ligament
and tendon strength by checking your hip's
range of motion. Your posture and ability to transfer
weight usually is examined as you stand, sit, lie down,
and stand again. The symmetry of your hips and the length
of each leg may be measured. Your physician also checks
for bruises, cuts, redness, or swelling. You may undergo
a neurovascular examination to check your reflexes and
pulse. Your physician may administer a number of muscular
strength tests. While your leg is held with resistance
from your physician, you may be asked to bend and rotate
your hip in various directions to see what movements
cause pain. Depending on what your physician suspects
is causing synovitis, you may undergo further physical
examination to diagnose arthritis, cartilage damage,
or other hip problems.
Your physician usually takes a small
blood sample with a needle to perform a complete blood
count (CBC) or a rheumatoid factor analysis, which tests
for rheumatoid arthritis. A urine sample may also be
needed to rule out infections. Should your physician
require a closer look, MRI
(magnetic resonance imaging) is generally the best method
for obtaining a clear picture of synovitis. MRI can
sometimes be used to catch minor synovitis before the
swelling becomes painful and visible to the eye. X-rays
may also be taken of your hipbone, thighbone, and knee
to check for any bone abnormalities. If your physician
suspects synovitis, your physician may use a needle
to remove some of the fluid from your hip which is then
tested in the laboratory. Synovial fluid that is infected
by synovitis has unique characteristics that can be
tested to make the final diagnosis.