_Synovitis._--When a joint has been injured, inflammation occurs in
the damaged tissue; that is inevitable. But sometimes the attack of
inflammation is so slight and transitory as to be scarcely noticeable.
This is specially likely to occur if the joint-tissues were in a state
of perfect nutrition at the time of the hurt. But if the individual or
the joint were at that time in a state of imperfect nutrition, the
effects are likely to be more serious. As a rule, it is the synovial
membrane lining the fibrous capsule of the joint which first and
chiefly suffers; the condition is termed _synovitis_. Synovitis may,
however, be due to other causes than mechanical injury, as when the
interior of the joint is attacked by the micro-organisms of pyæmia
(blood-poisoning), typhoid fever, pneumonia, rheumatism, gonorrhoea or
syphilis. Under judicious treatment the synovitis generally clears up,
but it may linger on and cause the formation of adhesions which may
temporarily stiffen the joint; or it may, especially in tuberculous,
septic or pyæmic infections, involve the cartilages, ligaments and
bones in such serious changes as to destroy the joint, and possibly
call for resection or amputation.
The symptoms of synovitis include stiffness and tenderness in the
joint. The patient notices that movements cause pain. Effusion of
fluid takes place, and there is marked fullness in the neighbourhood.
If the inflammation is advancing, the skin over the joint may be
flushed, and if the hand is placed on the skin it feels hot.
Especially is this the case if the joint is near the surface, as at
the knee, wrist or ankle.
The treatment of an inflamed joint demands rest. This may be
conveniently obtained by the use of a light wooden splint, padding and
bandages. Slight compression of the joint by a bandage is useful in
promoting absorption of the fluid. If the inflamed joint is in the
lower extremity, the patient had best remain in bed, or on the sofa;
if in the upper extremity, he should wear his arm in a sling. The
muscles acting on the joint must be kept in complete control. If the
inflammation is extremely acute a few leeches, followed by a
fomentation, will give relief; or an icebag or an evaporating lotion
may, by causing constriction of the blood-vessels, lessen the
congestion of the part and the associated pain. As the inflammation is
passing off, massage of the limb and of the joint will prove useful.
If the inflammation is long continued, the limb must still be kept at
rest. By this time it may be found that some other material for the
retentive apparatus is more convenient and comfortable, as, for
instance, undressed leather which has been moulded on wet and allowed
to dry and harden; poro-plastic felt, which has been softened by heat
and applied limp, or house-flannel which has been dipped in a creamy
mixture of plaster-of-Paris and water, and secured by a bandage.
Public-domain text, read in full here on John Shaqi.
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