Sometimes I wonder what is the most common reason for people to visit an orthopedic surgeon, and I've come to the conclusion that it's pain, pain from a variety of causes. In the orthopedic clinic, the most frequent patients are cervical spondylosis, lumbar disc herniation, trauma, strain injury, frozen shoulder, synovitis and other pain-based diseases.
Today we are sharing knowledge about synovitis (bursitis) and some of the myths and pitfalls.
The article is quite long, please be patient and correct any mistakes
Synovitis is a condition in which the synovial membrane is irritated and produces a sterile inflammation, and the inflammation leads to an imbalance in the synovial membrane's secretion of fluids to form an effusion. Synovitis can occur in various parts of the body, including the finger joints, elbow joints, knee joints, ankle joints, and hip joints.
Synovitis is a broad concept, as most arthritis is accompanied by synovial lesions (rheumatoid, gouty arthritis, etc.), with the exception of simple synovial lesions (e.g., prepatellar bursitis, retropatellar bursitis, pigmented choriocarpal nodular synovitis, etc.).
Two points must be made clear about this concept!
① stimulus : mechanical stimulus, traumatic stimulus, long-term strain stimulus, arthropathy (gouty arthritis, rheumatoid/rheumatoid arthritis, etc.!).
② inflammation : simple classification can be divided into aseptic inflammation (such as osteoarthritis, a variety of physical and chemical stimuli caused by inflammation), infectious inflammation (such as pneumonia and other bacterial, fungal, and other pathogens caused by the infection of inflammation), autoimmune inflammation autoimmune inflammation (such as allergic rhinitis).
Of course, this categorization may not be accurate. The main emphasis here is that synovitis is primarily an aseptic inflammation.
#TheTruthComesIn
There is one pitfall about inflammation that must be avoided: anti-inflammatory! There is no such thing as an anti-inflammatory in the classification of drugs! Generally speaking, people refer to anti-inflammatory drugs as antibiotics! Common antibiotics are mainly several categories: beta-amides (penicillin, cephalosporins and carbapenems), quinolones (levofloxacin, etc.), aminoglycosides (gentamicin, etc.), macrolides (erythromycin, etc.), tetracyclines, sulfonamides. Regardless of the class of antibiotics, the "raw" mainly refers to bacteria, fungi and other microorganisms. Then he is aimed at the infectious inflammation.
Synovitis is not effective!
The answer is yes!
NSAIDs have a clear anti-inflammatory and analgesic effect on sterile inflammation!
Non-steroidal anti-inflammatory drugs are very common in our daily life: paracetamol (acetaminophen), diclofenac (diclofenac sodium), Enrico (ibuprofen) acetylsalicylic acid (aspirin) fenbendazole (ibuprofen) and so on!
Clinicians often use these drugs to relieve pain in patients. These drugs have some adverse effects. The use of long-term, large quantities can lead to serious consequences. Please consult your physician before using them!
Those of you reading this may be wondering if there are steroidal anti-inflammatory drugs, since there are NSAIDs.
The answer is also yes!
But ......
Steroidal anti-inflammatory drugs actually refer to glucocorticoids, which can be directly understood by non-medical friends as hormones, and anti-inflammatory are The anti-inflammatory is one of the basic role of the hormone. Regardless of the various periods of inflammation have a clear effect, and the effect is relatively good! The adverse effects of long-term use of hormones should not need me to popularize again! Just one sentence to summarize will make the body endocrine system collapse, causing a variety of diseases
Hormones can be said to be a "miracle drug"
In the jungle, a variety of treatment of joint pain in the ancestral recipe, especially those who claimed to use a good "joint pain terminator". Most of them contain hormones ( Health Bureau, Food and Drug Administration, CCTV and other authorities often report such incidents ). Clinically, it is common to see patients hospitalized because of long-term use. In orthopedics, the most common is hormonal necrosis of the femoral head!
Tell a story: when our hospital, a doctor, claiming to have ancestral secret recipe, do their own home pills to the hospital to sell, was found by the hospital dismissed, home to do their own health bureau found revoked license, still doing, was arrested and sentenced to two years, is still active in the network, I guess the annual conservative income of a million!
The purpose of telling this story is just to tell everyone, don't be fooled!
Consider the issue from another angle, if his drugs, or the drugs of some god doctors on the network have a clear effect. Is there still a need to hawk it between the workshops? Or is there still a need to yell on the internet? Apply for a patent, commissioned production, their own home can be counted before counting to soft! I'm not sure how much the market capitalization of Yunnan Baiyao is, but it's $100 billion!
Back to business!
Synovitis can occur in all joints of the body. The knee synovitis, elbow synovitis, and so on! Here is an example of synovitis of the knee to talk about prevention.
The prevention of bursitis is analyzed by the causative factors!
①Physical stimulation (the most common factor):
Physical stimulation is mainly caused by trauma, strain and other reasons!
The synovial membrane of the knee joint after trauma is stimulated by violence or long-term strain, resulting in abnormal secretion of synovial fluid, the bursa inflammatory reaction, it will cause local swelling and pain, joint cavity effusion and other symptoms of synovitis! Similarly, there is a synovial membrane on the anterior side of the patella, which can cause prepatellar cysts and pain when stimulation occurs!
It is important to note that in recent years it has been common to see patients with synovitis caused by excessive square dance, ghost dance, fitness and other physical exercise.
Prevention:
② Disease:
Disease caused by synovitis is common, such as gouty arthritis, rheumatoid arthritis, and other diseases caused by synovial lesions caused by a series of pain, swelling and other symptoms of the disease.
Prevention:
Why is synovitis so disturbing to everyone, and even believe in the "miracle doctor". There are two main reasons: 1. recurring attacks. 2. some of the diseases caused by synovitis can not be completely cured (such as rheumatoid arthritis, gouty arthritis). I often say a sentence: The disease that can be cured on the poles is precisely the problem that is difficult for hospitals. Let's brainstorm the reasons why!
To summarize the treatment of synovitis:
① Define the diagnosis, and the nature of synovitis!
② actively deal with the primary disease!
③ Use non-steroidal anti-inflammatory drugs according to the doctor's instructions to relieve symptoms!
④ local physical therapy and other physical therapy!
⑤ Cut off the cause of the disease!
⑥ According to the needs of the disease to choose whether to need surgical treatment!
① the relationship between the bursa and synovial membrane: synovial membrane and bursa from the anatomical point of view of the analysis they are different tissues, the bursa, also known as synovial sac, synovial sac, for the fibrous tissue pouch, the bursa wall is divided into two layers, the outer layer of thin dense connective tissue, the inner layer of synovial membrane, the formation of the fissure-like cavity, when normal, there is a small amount of synovial fluid inside to reduce the friction between neighboring tissues. The synovial fluid can be interpreted as lubricant, the bursa is the factory that constantly produces lubricant, and the synovium is the machine that produces the lubricant!
② bursitis is synovitis are a kind of aseptic inflammation, most of the common synovitis, bursitis is to bursa, synovial membrane at the same time lesions.
In summary, the synovium is part of the bursa, and synovitis and bursitis can be understood as the same disease!
I'm @OrthopedicTraumaDrLiu , and that's all the knowledge I have to share with you today! The body is itself, and it's never too late to arm yourself with knowledge.
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