Fibrous ankylosis

Fibrous ankylosis

Infection

Published in Louis Solomon, David Warwick, Selvadurai Nayagam, Apley and Solomon's Concise System of Orthopaedics and Trauma, 2014

Louis Solomon, David Warwick, Selvadurai Nayagam

Joint tuberculosis may start either in the synovium or in a nearby metaphysis from where it spreads across the physis, through the articular surface into the synovial cavity. Either way, the presenting picture is of a chronic monarthritis affecting a large joint (usually the hip or knee, less often the shoulder or ankle). Secondary infection by pyogenic organisms is quite common. If the condition is not arrested, the articular surfaces will be destroyed. Healing is by fibrosis, resulting in a tight ‘fibrous ankylosis’ of the joint. Within this fibrocaseous tissue mycobacteria may lurk undiscovered, only to flare up again some years later.

Synovitis in hemophilia: preventing, detecting, and treating joint bleeds

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Journal Information

Published in Expert Review of Hematology, 2023

E. Carlos Rodriguez-Merchan

Occasionally, treatment of synovitis requires pain alleviation. Furthermore, some approaches to pain management also reduce inflammation and ameliorates synovitis. Multimodal pain treatment, including multimodal analgesia, PRM, and psychological therapies (imagery or relaxation, hypnosis), is the most recommended approach for patients with hemophilia. Paracetamol/acetaminophen should be recommended if the pain is mild, metamizole if the pain is moderate, and soft opioids (codeine or tramadol) if the pain is severe. Sometimes COX-2 inhibitors, intra-articular injections of hyaluronic acid, and behavioral therapies are required [41,42]. Post-synoviorthesis rehabilitation is paramount to reducing the risk of fibrous ankylosis of the joint [39].

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Infection

Synovitis in hemophilia: preventing, detecting, and treating joint bleeds