Synovitis is swelling (inflammation) in the synovial membrane that lines some of your joints, including your hip joint, and can cause considerable pain. If left untreated, your hip pain may continue to worsen, which can make movement increasingly difficult. You can develop more and more synovitis which can eventually lead to the destruction of articular cartilage which is the smooth, white tissue that covers the ends of bones where they come together to form the joint. Trying to ignore hip pain and swelling may result in a more serious underlying condition going undiagnosed. To avoid this, the place to start is at OCC – Advanced Orthopedic & Sports Medicine Specialists in Denver, Parker, or Aurora, Colorado. Their orthopedic specialists have extensive experience diagnosing and treating synovitis of the hip. Well-qualified and compassionate, they can be your trusted partner in the journey to a healthier, more active, pain-free life.

OVERVIEW

All the freely movable joints of the body have a lubricating lining called the synovial membrane. Any joint in the body that has a synovial membrane can develop synovitis including the hip. The synovial membrane produces more than its usual thin film of lubricating fluid when it is inflamed and this can result in severe pain in the joint. When the synovial membrane becomes inflamed for a short period, it is often referred to as “transient” synovitis. Hip synovitis can be associated with various conditions like osteoarthritis, rheumatoid arthritis, or trauma. In people with hip osteoarthritis, some studies have shown that synovitis can be found in about 40-70% of patients, depending on the severity and diagnostic methods used.

ABOUT THE HIP

The hip joint is one of the largest joints in the body. The hip joint is a connection point between the legs and torso. It is a ball-and-socket joint. The socket is formed by the acetabulum, which is part of the large pelvis bone. The ball is the femoral head, which is the upper end of the femur (thighbone). This type of joint offers a wide range of motion and provides support for the legs to hold the body. The function of the hip joint is to provide balance and support for the upper body, move the upper leg, and hold one’s body weight. The ball and socket joint lets the upper leg move at 3 degrees to allow for the following movements:

• Flex
• Extend
• Rotate
• A back-and-forth motion
• A circular motion

Each hip bone is made up of three bones. It may look like one bone, but each hip bone is made up of the ilium, pubis, and ischium, which are completely fused.

WHAT IS SYNOVITIS OF THE HIP

Synovitis (or synovial inflammation) is when the synovium of a joint becomes inflamed (swollen). The synovium, which is also sometimes called the stratum synoviale or synovial stratum, is a connective tissue that lines the inside of the hip joint capsule. A joint capsule, also called an articular capsule, is a bubble-like structure that surrounds joints. It is composed of a tough, outer layer called the fibrous stratum and a soft inside layer (the synovium). Contained inside both layers is synovial fluid, a viscous liquid that lubricates the joint to reduce friction on the articular cartilage during motion. The joint capsule ensures that the joint is sealed, thus keeping the synovial fluid within the joint. Synovitis comes in several forms including:

• Acute synovitis—this causes the joint volume to increase for a few hours to an entire day
• Chronic synovitis—not as common as acute synovitis
• Reactive synovitis—an uncommon type of synovitis causing an increase in the volume of fluid in the joint
• Post-traumatic synovitis—the most common type. When the synovium becomes damaged, the body reacts causing pain and swelling

CAUSES

There are several potential causes of synovitis:

• Loss of cartilage to the joint
• In an active, healthy person, the most common cause is overuse of the joint, for example in athletes or people whose jobs involve repetitive stress movement such as squatting
• Labral tear—a tear to the “socket” of the ball-and-socket hip joint
• Osteoarthritis and Chondropathy—wear and tear of the joint and damage to cartilage
• Ligament teres tear—the ligamentum tere is a ligament that joins the pelvis to the head of the femur (thigh bone)

SYMPTOMS

Symptoms may include:

• Hip pain (usually on one side only)
• Night pain
• The Joint becomes warmer due to increased blood from inflammation
• Joint pain in the groin region
• Pain when exercising and at rest
• Limp
• Walking will be uncomfortable and may make symptoms worse

NON-SURGICAL TREATMENTS

A mild case of synovitis may prompt a “wait and watch” approach. Other conservative approaches may include:

• Anti-inflammatory drugs (NSAIDs) such as aspirin, and ibuprofen
• Oral drugs known as DMARDs (disease-modifying antirheumatic drugs)
• Steroid injections
• Application of heat to the joint
• Rest/avoid bearing any weight on the joint

WHEN IS SURGERY INDICATED?

If the condition does not resolve remarkably in two or three days, the patient may need a synovectomy(removing the inflamed tissue) that can reduce the associated pain significantly. When a portion of the compromised synovium is taken out the surgeon may achieve this by suction or shaving tissue through arthroscopic surgical tools. Hip arthroscopy is a minimally invasive procedure for diagnosing or treating joint problems. A surgeon inserts a narrow tube attached to a fiber-optic video camera about the size of a buttonhole. The view inside the joint is transmitted to a high-definition video monitor to pinpoint the problem and make the surgical process more accurate.

GETTING THE RIGHT DIAGNOSIS.  GETTING THE RIGHT DOCTOR.

The main concern when diagnosing transient synovitis of the hip is differentiating it from septic arthritis. A joint with septic arthritis will have pain with any attempted range of motion. It can destroy joint cartilage and cause permanent damage to the joint. This why you want a skilled orthopedic specialist with years of experience diagnosing and treating synovitis like those you’ll find at OCC – Advanced Orthopedic & Sports Medicine Specialists in Denver, Parker, or Aurora, Colorado. Another aim will be to diagnose the cause of the patient’s pain by first determining whether it is inside the joint itself, meaning true synovitis, or if it is caused by another type of inflammation. Some different diagnostic tests that may help your doctor diagnose hip synovitis include:

• X-rays to evaluate the source of the pain
• Ultrasound to determine a joint effusion (extra fluid flooding the tissues around your joint)
• MRI to detect abnormalities such as periarticular pyomyositis or osteomyelitis
• Culture test to test the synovial fluid in the joint

The real test is how capable, caring, and accomplished your doctor is. That makes all the difference. This is why there is no question you should choose to get the best care and the best possible outcome from Advanced Orthopedics.