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Verrucous Nodular Synovitis

  Hyperpigmented villonodular synovitis is a type of proliferative lesion of synovium, which often presents as localized nodules. The mass may originate from the synovium of the joint, tenosynovium, fascial layer, or ligament tissue. The lesion is manifested as painless soft tissue mass, usually located at the fingers and toes. It can also be seen in other joints (especially the knee joint) and tenosynovium. Unicompartmental onset is a regular feature of the disease, but there are also rare cases of polyarticular lesions.

Table of Contents

1. What are the causes of the onset of villonodular synovitis?
2. What complications can villonodular synovitis easily lead to?
3. What are the typical symptoms of villonodular synovitis?
4. How to prevent villonodular synovitis?
5. What laboratory tests should be done for villonodular synovitis?
6. Diet taboos for patients with villonodular synovitis
7. The routine method of Western medicine for the treatment of villonodular synovitis

1. What are the causes of the onset of villonodular synovitis?

  The etiology of villonodular synovitis is unknown and may be a synovial disease between inflammation and benign tumor. The villous type is more similar to inflammation. Animal experiments have shown that repeated injection of blood into the joint cavity can produce pathological changes similar to those of the villous type. Athletes who have multiple knee hemorrhages may also produce similar changes. The nodular type is composed of a large number of synovial cells, and it is easy to relapse if not completely removed, so it is similar to a benign tumor.

2. What complications can villonodular synovitis easily lead to?

  Villonodular synovitis can be complicated with joint hemorrhagic effusion and bone destruction. Bone destruction is manifested as localized bone density reduction, sparse or blurred trabeculae, erosive or sieve-like bone cortex, local bone defect or structural disappearance in imaging, which is commonly seen in bone inflammation, granuloma, tumor, or tumor-like lesions in clinical practice.

3. What are the typical symptoms of villonodular synovitis?

  Villonodular synovitis does not have obvious systemic symptoms, the patient's body temperature is not high, the erythrocyte sedimentation rate is not fast, and there is no change in the blood picture. Local symptoms are also mild in the early stage, so patients seek medical attention late, and the disease course is long. Generally, the disease course of 1 to 5 years is the most common, and more than half of the patients have a history of trauma. The main symptoms of this disease are joint swelling, and the pain is usually mild. The local skin temperature is sometimes slightly high, and the limitation of joint function is not obvious. The joints with diffuse swelling feel spongy when touching the thickened synovium. The joint effusion can be felt fluctuating. Sometimes, nodules of different sizes that can be slightly moved can be touched.

4. How to prevent villonodular synovitis?

  Rational prevention is an important method to reduce the occurrence of diseases. Next, I will introduce the preventive measures for this disease:

  1. Eliminate and reduce or avoid the factors leading to the disease, improve the living environment and space, develop good living habits, prevent infection, pay attention to dietary hygiene, and make reasonable dietary arrangements.

  2. Pay attention to physical exercise, increase the body's resistance to disease, do not overwork, do not over-consume, quit smoking and drinking.

  Early detection, early diagnosis, and early treatment, build confidence in overcoming the disease.

5. What laboratory tests are needed for verrucous nodular synovitis

  Verrucous nodular synovitis can usually be diagnosed by the following examinations:

  1. Routine blood tests, erythrocyte sedimentation rate, rheumatoid factor, and C-reactive protein tests show no significant changes.

  2. Joint puncture for joint fluid extraction is mostly bloody, but can also be orange-yellow.

  3. The X-ray findings depend on the location of the lesion.

  4. CT scan can show hemosiderin, the extent of synovial lesions, and the situation of bone cystic degeneration and erosion. If there is widespread hemosiderin deposition, it appears as increased density on CT.

  5. MRI shows hemosiderin in T1 and T2 weighted images as low signal or no signal.

  6. Angiography shows rich blood supply to the lesion, but in the late stage of the lesion or when the lesion is obviously fibrotic, angiography shows little blood supply to the lesion.

6. Dietary taboos for patients with verrucous nodular synovitis

  There are no special dietary requirements for patients with verrucous nodular synovitis. General normal diet is sufficient. Pay attention to a rich diet, balanced nutrition. Ensure the needs of the human body for heat, protein, and vitamins required for normal metabolism. Increase the intake of vegetables and fruits appropriately. In terms of health care, pay attention to relaxing the mind, building confidence, maintaining a good attitude, and actively cooperating with the doctor's treatment.

7. Conventional methods for the treatment of verrucous nodular synovitis in Western medicine

  The onset age of verrucous nodular synovitis is mostly in young and middle-aged adults aged 20-40. The disease is not suitable for conservative treatment. Early surgery or radiotherapy should be performed to根治 the lesion and block its development and malignant transformation. Radiotherapy after surgery can consolidate the therapeutic effect. For diffuse nodular lesions of the knee joint, the cruciate ligament and collateral ligament should be cut, and for localized lesions, only the local synovial tissue needs to be excised.

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