FAQ - synovitis
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Arthroscopy ankle surgery?


Hello, I just got ankle arthroscopy done today and I was told that I had a severe ankle sprain with reactive synovitis. I was wondering what that meant and about how long my recovery would be. Also about how long I would be on crutches without any weight bearing. Thank you!
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So, a "severe ankle sprain" likely means that you either over-stretched or tore several of the ligaments that support your ankle and help the many different joints work together in activities such as walking. "Reactive Synovitis" means there's inflammation in/near the articular surfaces (where bones meet) of at least one of the joints in your ankle. This may or may not indicate the presence of an infection, so you'll want to follow-up with your doctor and/or surgeon ASAP to learn more. The synovitis may be the cause of any pain you've been having prior to surgery.

In terms of weight bearing, that's up to your surgeon - and each surgeon tends to have his/her own beliefs about how long you should be off your feet. He/she should have told you how long you'll be on crutches - if not, you need to ask. I can say, for certain, that you can't rush things - if you do, you risk doing more damage to your ankle ligaments and set yourself up for future sprains.

Hopefully, your surgeon has given you a referral to Physical Therapy which will help decrease pain, get back strength and range of motion, and help you get back to "normal" as soon as possible. It's important that you do exercises they teach you as they'll help your ankle to heal and help you stay injury-free heading into the future.

Sorry this is so long winded, but I hope this helps!  (+ info)

MRI report?


since I live in NJ and got hurt on the job my workmans compansation dr, won't tell me what is wrong with my shoulder He wouldn't even give me a copy of the MRI. Well I got a copy of the MRI today and I need to know what it means because this Dr. won't tell me anything.
what is a longitudinal tear of the superior labrum into the anterior and posterior labrum to the level of the equator compatable with a slap. There is also moderate tendonosis and intrasubstance split of the proximal intra-articular biceps.
there is also a mild synovitis and capsular thickening in the rotator interval and axillary recess compatable with adhesive capsulitis.
Impression 1 Moderate rotator cuff tendonosis
2 Slap tear extending into the proximal intra-articular beceps tendon
3 Adhesive capulitis.
It states no full thickness rotator cuff tear. All I know is the Dr. works for the insurance and not for me so I'm trying to get all the information I can get.
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basically you have a torn ratator cluff and damage to the bicep muscle. you will need surgery. HIRE A LAWYER NOW, OR THEY WILL SCREW YOU OVER.  (+ info)

Gout attack?


I have had extreme pain, swelling and stiffness in my big toe joint for three months. It started there and within about 3 weeks my ankle swelled up and the pain is excruciating. I can't put a shoe on anymore because my foot is so swollen. I had MRIs with an orthopedist which showed synovitis and rheumatoid problems. I have an appt. with the rheumatologist in a couple of weeks and will suffer until then. The ortho mentioned gout. My symptoms seem consistent however I am a 30 year old woman, 5'7", 115 pounds and my diet is really healthy - I make all my food which is usually chicken or fish, veggies, fruit, cereal, brown rice...not bad at all. I don't fit the profile of gout at all. Is it possible???
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Gout would be in the differential diagnosis. It is more likely if there is a positive family history, or if you have elevated levels of uric acid. Toes and ankles are frequent sites of gout attacks.

Rheumatoid arthritis is another possibility. It's too bad the rheumatologist can't see you any sooner. Any chance you can push for an earlier appointment?  (+ info)

Post Shoulder arthroscopy , pop sound?


I done my shoulder arthroscopy surgery in may. This is wud my MRI says: Severely fragmented and irregular anterior glenoid labrum with partial detachment and extension into the superior labral attachment with a definite SLAP I tear. Chronic anterior glenohumeral synovitis.

I started my rehab 6 weeks post op but till now there is still a pop sound when i execute some motions etc punch my hand forward or raise my hands up. There is also slight pain whenever i raise my hands up

Any idea if this is normal?
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This does not sound normal. I would recommend getting in touch with your doctor today to let them know what's going on so that they can evaluate the situation further.  (+ info)

pregnant. questions about cesarians.?


Im 17yrs old., I had an operation on my hip 4 months ago, its still not fully healed properly., I have 2 metal pins in my hip bone, and have found out the cysts are growing back again.. I have an ongoing disease called 'pigmented villonodular synovitis' I also think my other hips going too, but I can't have a MRI scan until bubs born. Im 17wks 3days pregnant... my midwife suggested me to elect a cesarian as its probably safer for me and my baby...

Was just wondering how quickly you healed after having one?

And also how many wks gone were you when they performed the cesarian ?

Thanks :)
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It takes ages. It took my sister nearly 2 years. She went in at exactly 40 weeks.


Goodluck  (+ info)

Wrist Ligament Damage?


I just got my results back from a wrist injury I did 6 weeks ago. The MRI from 4 days ago says - Small perforation of the dorsal band of the scapholunate ligament with some minor overlying synovitis. The volar band of the scapholunate ligament is intact, although the most inferior fibres are thickened and heterogenous. Also, partial tearing of the inferior fibres of the volar band of the scapholunate ligament with a 1 x 5mm ganglion which projects from the anterior portion of this ligament. There are good quality intact dorsal and volar band fibres. The scapholunate articulation is congruous.

My GP says I may need surgery. Anybody out there have ideas or thoughts about this type of injury and the chances that I may need surgery to repair. Is there any chances that they injury may correct itself - GP does not think so and is sending me to a surgeon - 8 weeks away to get into him.
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ACL deficient living - why or why not?


I recently discovered that when I "sprained" my left knee 18 months ago, I actually completely ruptured my ACL. My orthopedic surgeon says I've been compensating remarkably well, and might not need reconstructive surgery. However, what finally got me to the point of the arthroscopic surgery at all was the continual grinding and occasional falling - which of late, has gotten much more frequent.

I understand that the muscles surrounding the knee have weakened over time, and physical therapy may decrease the incidence of falling in the future. However, I am afraid that isn't going to help the grinding much. Bear in mind, when I say "grinding" I should specify that it is really more like "grinding to a halt". The knee doesn't exactly "lock," as I CAN bend the knee by myself after this, and again, I can usually compensate for this by lifting my leg higher and doing a quick bend in the opposite direction, but it's really uncomfortable (though again, not acutely painful). I also stumble frequently, but can usually recover. This occurs while walking normally. On the other hand, when the knee completely gives and I fall, it's excruciating.

I should also add that my doctor did not find significant instability at the original examination a year ago, though the "grinding" that drove me to him was the same then as it is now, and was from the time of injury. Also, I do have arthritic development, but my meniscus is currently whole.

To be fair, it's only been two weeks since my arthroscopic surgery, and my surgeon removed significant (unable to see my patella at all on entry) synovitis and scar tissue, some of which was literally "sanding away" at my femur, leaving bright red raw streaks, but my personal suspicion is that this stuff developed in response to the grinding, and is not the cause of the grinding.

I cannot, since the original injury, hop more than 4 or 5 times on that leg without falling completely, or run at all beyond a shuffling jog. I am pessimistic as to whether physical therapy will help that either.

I really don't want another surgery, though, and am wondering if there are any other ACL deficient folks out there who are "compensating" without reconstructive surgery, and what are reasonable expectations? I'm really having trouble making up my mind what to do.
I'm NOT hopping post-surgically, I'm being VERY compliant. However, the ability to hop and run has been lacking for the last 18 months (since the original injury) and I doubt 2 or 3 months of physical therapy is going to change that, especially since this leg used to be my "anchor leg" before the injury. The same for the grinding. I'm pretty sure synovitis takes TIME to grow, thus the removal of said growth isn't going to have much effect on the overall stability of the knee.

I'm more interested in whether this is acceptable long-term and is there anyone else out there lifiving with a similar condition.
I'm NOT hopping post-surgically, I'm being VERY compliant. However, the ability to hop and run has been lacking for the last 18 months (since the original injury) and I doubt 2 or 3 months of physical therapy is going to change that, especially since this leg used to be my "anchor leg" before the injury. The same for the "grinding to a halt," present from the day of injury. I'm pretty sure synovitis takes TIME to grow, thus the removal of said growth isn't going to have much effect on the overall stability of the knee.

I'm more interested in whether this is acceptable long-term and is there anyone else out there lifiving with a similar condition.
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If you've only had surgery and are hoping on it, you are trying to push this too hard too soon. You should be waiting about 2-3 months before trying any type of high impact activity. The grinding can certainly be caused from the synovitis and scar tissue...since he cleaned up some of this, (which can be quite traumatic to the knee) it will still take some time for this to subside.

Could the grinding also be caused by a functional instability? Absolutely. Even though your static stability may be OK, if your dynamic stability is deficient, it can lead to feeling of giving way. It's too soon to say. However, the current trend is to avoid repairing the ACL except in highly active young people. It can always be done later if need be.

Best wishes.  (+ info)

my 18 month old son suddenly stopped walking?


Hello, its 12 days my son unable to walk. He is 18 month old, and all his vaccination up to date ( only DPT and HIB,Polio are due to be done now at 18month) We still don’t know what is exactly his problem, as all test came negative (ultrasound, x-ray and blood test), he is not running fever. Overall he is active, crawling, lifting himself up to the sofa, but when it comes to stand he can’t bear weight on his left foot slightly lifting upwards and sometimes he complains about his left hand just for a seconds. We have consulted with orthopedic doctor locally and according all test doctor couldn’t find any serious reason. He diagnosed him with irritable hip or acute transient synovitis relating this with his recent ear infection. We keep on giving Brufen syrup 3 times a day and so far I don’t see any improvement. Does anyone know what's happening with my child or anyone experienced something similar to that? Please send me your advice to [email protected]
We live in Africa, but due to the current problem planning to make an urgent trip for India.
Thank you
Aisha
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I have fluid in my knee how do I cure it?


I just got my tests back it was found that I have fluid on my knee the Dr. said that it was synovitis. What do I do to get rid of this? I want to start working out again doing my normal routine. The Dr. said that I can't do any heavy weight lifting with my legs. I'm not happy with his diagnosis there must be something that I can do to cure this. Anyone have this or know what I can do.
The Dr. is refusing to have this procedure done he won't do anything to treat this.
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Surgery to drain the fluid from the knee. Repair time, about six week to 2 months. If not treated, you may experince painful movements in the knee.  (+ info)

Severely damaged ligaments in ankle. Doctors, do you have an opinion?


History:
2 years ago I severely sprained my left ankle, I had a complete tear in my ATFL and a partial tear in my CFL. I am also born with an accessory bone on my Navicular which then fused to the Cuneiform next to it via cartilage. That sprain was treated on my own since I didnt have health insurance. I used crutches for 3 weeks while using RICE. The ankle and its ligaments healed, yet I had developed Posterior Tibial Tendinitis and was experiencing an aching pain on the medial side of my foot (where that fused lump is located) in the mornings, after exercises, and after standing up over 20 minutes.

After nearly 9 months of that pain, I took 6 weeks off from any physical activity as hand surgery prohibited my participation in any sport. That sore/dull pain went away.

I now have been able to play basketball, football, and soccer completely pain free for about 14-15 months. Now that is that is the ankles history, lets move on to where it gets tricky.


1 month ago I incurred another ankle inversion on that same ankle while coming down awkwardly off a rebound in a game of basketball. This time I have insurance and made an appointment with my local Podiatrist. He ordered an MRI and it showed:


-Bifid os tibiale externum and slight edema at the synchondrosis associated with midfoot pronation and posterior tibial paratendinitis.

-Peroneal tenosynovitis with slight adhesion's within the peroneal tendon sheath, an os peroneum, and mild peroneus longus tendinosis proximal to and within the cubital tunnel, but no morphologic high grade tear.

-Anterior Talofibular ligament is torn.

-Mild Achilles tendinosis without tearing or advanced tendinopathy.

-Tibiotalar and posterior subtalar joint effusions with synovitis and/or hemorrhage. Mild talonvaicular and naviculocuneiform degenerative changes.


(Speaking with my podiatrist and doing my own research on these terms I completely understand what is going on with the ankle.)

The ankle was mildly swollen, no discoloration, and I was able to bear weight on it with a slight limp the very next day; however that old aching dull pain came back. Im thinking tendinitis again. After being in a Cam-walker for 1 month I was ordered for physical therapy and didnt need the boot anymore. My physical therapy was mainly just for the tendinitis so it involved a lot of stretches and electro-stimulation therapy.

Since I was in the cam-walker for a month, the pain went away. So I decided to tape my ankles up and get back to running and getting back on the basketball court. Well after 2 days of 70% basketball, the ankle felt perfectly fine during and after the game. On the 3rd day of basketball, I inverted my ankle while jumping up off an opponents foot and re-tore my ATFL and possibly my CFL as well.

This is the 2nd ATFL tear in the last 35 days, and the 3rd in its lifetime. Also, that fused bone on the medial side of my foot is aggravating the tibialis tendon trying to enter into it.

I am going to see my podiatrist tomorrow morning, but wanted to see if anyone else has an opinion on what I should do from here on out.

My questions are:

1. With two grade 3 sprains in the past 35 days, does this diagnose me with Chronic Ankle Instability?

2. Should surgery be an option to repair the ligaments that have been torn a few times and to shave that accessory bone deformation down to relieve stress on the tibialis tendon?

3. If healing conservatively, is there a chance to get back to full strength if rested the proper amount of time (several weeks) followed by a more intense physical therapy to help strengthen the muscles and ligaments damaged?

4.Can the ATFL naturally heal after two severe injuries to it within 35 days, or is surgery a must?

5. Since I was able to play going about 70% with 0 pain during and after, was this last inversion simply bad luck, or was it because the ligament wasn't fully healed?
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1. Yes, absolutely. Chronic Ankle instability is more of a subjective diagnosis based on your ability to function, but it sounds like your ankle is pretty jacked.

2. An orthopedic foot or sports med specialist can perform a bronstrom repair to re-attach your ATFL and tighten your CFL. While they were in there, they could probably deal with the accessory navicular. It would be a significant surgery and require some serious PT and rest, but it would eventually get you back on your feet. You're talking about roughly 4 weeks of non weight bearing followed by another 4 in the boot. This would probably help with the posteior tibialis tendonitis eventually.

3. Typically when an MRI reports that a ligament is torn, that means it's torn all the way through and basically gone. Your ATFL may scar down to a certain degree, but would always be very loose. I think at a bare minimum, you'd be doing regular ankle exercises, like daily, and wearing a quality brace for many years. While it's not an easy decision, I've seen some good results from the Bronstrom repair, including one girl playing Div. I college volleyball.

4. See the first part of answer 3

5. Once you have a few good sprains, you're always more likely to sprain again. In addition to having very loose ligaments, your peroneal muscles (which are responsible for protecting against inversion sprains) tend to have reduced reaction time and poor proprioception. A lot of the PT exercises they made you do were to re-train your peroneals.

One other thing that stands out in your MRI is the "Mild talonvaicular and naviculocuneiform degenerative changes." This basically states that you're starting to develop some arthritis in the ankle. The fact that you're not hurting right now is good, but that's the sort of injury that catches up to you at 55 or 60 years, sometimes earlier.

I'm assuming you're a younger person so you have to think about the long term health of your ankles. All in all, you might have to transfer your care to an orthopedic foot/ankle surgeon. I don't know what surgical procedures your podiatrist does. You kinda got delt a bad hand, good luck with everything.  (+ info)

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