Swollen, painful knee joints, difficulty walking, young woman was suddenly discovered to have knee synovitis

Frequent knee pain, knee effusion for a long time, even had to have knee fluid drained many times but the disease did not go away and had difficulty walking. The girl went to the hospital and was discovered by the doctor to have the disease. rarely.
Information from Hospital E said that doctors from the Department of Orthopedic Surgery, Hospital E have just successfully performed laparoscopic synovectomy to treat pigmented hairy synovitis for a 16-year-old girl. year old.

Pigmented nodular synovitis is a rare disease, difficult to diagnose, causing severe pain and swelling, seriously affecting the patient’s motor system and quality of life.

The patient is only 16 years old, in Cau Giay, Hanoi) and has been suffering from swelling and pain in the left knee joint for a long time. During episodes of pain and swelling in the knee joint, the patient was examined at many medical facilities, used medical treatment, and had joint fluid aspirated many times, but the disease still recurred and the level of pain and swelling increased. The pain becomes increasingly severe and affects daily activities.

In the past few months, the patient has had pain, swelling and effusion in the left knee joint, and has difficulty walking. Through clinical examination and paraclinical results, the patient was diagnosed by the doctor of the Department of Orthopedic Surgery, Hospital E, as having pigmented nodular synovitis.

Doctor II Kieu Quoc Hien – Department of Orthopedic Surgery, Hospital E said that, based on medical history, the patient had pain and swelling in the left knee joint since the age of 8 with the diagnosis and treatment of juvenile arthritis. After that, the patient received medical treatment but still relapsed frequently and the disease became more severe.

Through examination, Doctor II Kieu Quoc Hien found that the patient’s left knee joint was swollen, had a lot of effusion, flexed the knee joint was painful, and the synovial membrane was thick. Ultrasound results also showed that the patient had a lot of joint effusion, the synovial membrane was very thick, forming thick clusters of fluid membranes. Magnetic resonance imaging (MRI) showed inflammation, thickening of the synovial membrane in the quadrant compartment, and uneven articular cartilage surface of the left knee. When the joint aspiration was performed, the joint fluid was red like blood and did not clot. Combination of clinical symptoms and paraclinical results determined that the patient had pigmented hairy synovitis and the doctors prescribed laparoscopic synovectomy to effectively treat the disease.

The laparoscopic synovectomy lasted 1 hour and ended smoothly. This modern surgical method allows doctors to observe almost all of the synovial membrane, every small nook and cranny of the joint, and intervene deeply into the joint area to remove damaged synovial membrane; Limit complications, risk of infection, bleeding… compared to traditional open surgery.

Doctor II Kieu Quoc Hien added that when performing arthroscopic surgery on the knee joint , the doctors saw that the joint fluid was red like blood and during irrigation, the synovial membrane floor was yellow due to the deposition of hemosiderin (also known as pigment). metal deposits in the knee joint) and the synovial membrane emerges with congestion concentrated in patches. Doctors decided to remove the entire synovial membrane in the patient’s knee joint.

Doctor II Kieu Quoc Hien affirmed that arthroscopic synovectomy is the best treatment method in treating this synovial disease. However, after surgery, it is necessary to monitor the progression of the disease. If the disease recurs quickly and the knee joint is completely damaged, the doctor will have to perform knee replacement surgery or local radiation therapy, helping the patient avoid the risk of losing mobility at the damaged joint.

According to Doctor II Kieu Quoc Hien, pigmented hairy synovitis is a disease of the synovial membrane that can occur in all synovial joints but is mainly found in the knee joint. Commonly seen after age 30, the injury causes swelling, pain, and the deposition of the metallic active ingredient hemosiderin in the joints. Common clinical symptoms are pain and swelling of the joints. Patients may have limited joint mobility, joint stiffness, and sometimes joint laxity.

It is worth mentioning that this disease is detected in patients aged 30-50 years, without gender factors. However, this patient suffered from a rare disease at the age of 8, which is too young and the cause and pathogenesis of the disease are unknown, especially in adolescence. The symptoms of the disease are easily confused with common tuberculosis, synovitis, polyarthritis, and rheumatism. The disease recurs over time, the level of joint destruction increases, and the patient is at risk of losing mobility in the affected joint.

Therefore, doctors recommend that early detection and treatment of pigmented hairy synovitis will help patients reduce joint pain and swelling, and improve the quality of movement.

Liliana Keeling

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