Transient synovitis

　　Transient synovitis is a multifaceted disease, mainly occurring at the knee joint. The approximate causes of transient synovitis are as follows:

　　1. Physical stimulation, such as bleeding stimulation from meniscus injury, cold stimulation.

　　2. Endocrine disorder, changes in hormone levels, such as synovitis during the menstrual period, pregnancy, postpartum, and menopausal period in women.

　　3. Cumulative stress, such as over-fatigue, over-loading, and surgery of the joint.

　　4. Bacterial infection, such as bacterial arthritis, tuberculous synovitis.

　　5. Juvenile synovitis generally belongs to viral infectious synovitis, also known as transient synovitis.

　　6. Immune system diseases, such as rheumatoid arthritis, Reiter's arthritis, and Sjögren's syndrome.

　　7. Chemical stimulation, such as over-acidity or over-alkalinity of the internal environment, such as gout uric acid crystals causing effusion within the joint.

　　8. Pigmented villonodular synovitis, which is caused by chronic inflammation stimulation or abnormal lipid metabolism, leading to thickening of the synovium in the knee joint, and having fine, long villi or nodular hyperplasia on the surface of the synovium. Its nature is between benign and malignant tumors.

　　9. Joint instability, including the instability of the joint caused by fresh or old ligament injuries, the synovium being compressed by bony structures, and the stimulation resulting in synovitis.

　　10. Stimuli from heterologous proteins, animal bites, etc., may cause transient synovitis.

　　Transient synovitis is an aseptic inflammation caused by poor microcirculation, the main symptoms being the formation of effusion. The synovium is a membranous tissue surrounding the joint, which not only serves as a protective tissue for the joint but also produces synovial fluid, providing 'lubricating fluid' for joint movement. The production and absorption of synovial fluid are a 'dynamic balance'. When there is a barrier to the reabsorption of synovial fluid, due to the disruption of the dynamic balance between production and absorption, with the production of synovial fluid exceeding reabsorption, 'joint effusion' occurs.

　　Synovitis is an aseptic inflammation caused by poor microcirculation, the main symptoms being the formation of effusion. There are many other symptoms associated with this condition, and a specific introduction is given below:

　　First

　　After waking up, the joints are stiff and it is difficult to get out of bed (usually about 1 hour), and it is necessary to slowly move around before walking, but still cannot engage in heavy exercise, otherwise the pain will worsen.

　　Second

　　Difficulty in squatting, partial dysfunction, or joint effusion, which is usually caused by inflammatory stimulation leading to exudative effusion in the joint.

　　Third

　　Patients feel fatigue, unable to use their strength, and the legs and knees feel sore and uncomfortable, with an indescribable feeling of discomfort. Appropriate massage can alleviate the symptoms.

　　Fourth

　　Difficulty in descending stairs, joint pain when ascending stairs, is often due to synovitis or lesions around the joint.

　　Firstly, excessive long-term intense exercise is one of the causes of synovial degeneration. Therefore, avoiding intense exercise is something that needs to be paid attention to in daily life, especially for weight-bearing joints (such as the knee and hip joints), excessive exercise increases the stress on the joint surface, leading to increased wear. Long-term intense exercise can also cause excessive stress and traction on the bones and surrounding soft tissues, resulting in local soft tissue injury and uneven stress on the bones, leading to bone hyperplasia.

　　Secondly, as mentioned above, avoiding long-term intense exercise does not mean that it is best not to exercise at all. On the contrary, appropriate physical exercise is one of the good methods to prevent bone hyperplasia. Because the nutrition of articular cartilage comes from synovial fluid, and synovial fluid can only enter the cartilage through 'squeeze', promoting the metabolism of cartilage. Appropriate joint movement can increase the pressure in the joint cavity, which is conducive to the penetration of synovial fluid into the cartilage, reducing the degenerative changes of articular cartilage, and thus benefiting the prevention of synovitis, especially the hyperplasia and degenerative changes of articular cartilage.

　　Finally, timely treatment of joint injuries is very important, which includes soft tissue injuries and bone injuries. The bone hyperplasia is often directly related to intra-articular fractures. Due to incomplete reduction of fractures, the articular cartilage surface becomes uneven, thus causing traumatic arthritis. For patients with intra-articular fractures, if timely treatment is received and anatomical reduction is achieved, it should be possible to avoid the occurrence of this disease and maintain a good mental state.

　　Transient synovitis is a type of synovitis, which generally occurs in the knee area. Usually, the following examinations need to be performed:

　　1. X-ray examination

　　The main manifestation is the prominence of the hip joint capsule shadow, and when the joint cavity effusion is severe, the head of the femur can be seen to shift laterally, the joint space widens, and there is no bone destruction.

　　2. Hip joint puncture examination

　　The puncture fluid is transparent, the bacterial culture is negative. The examination of the joint capsule synovial tissue shows non-specific inflammatory changes. The total white blood cell count may increase, and the erythrocyte sedimentation rate may be slightly elevated.

　　3. Laboratory examination

　　In most cases, the white blood cell count and erythrocyte sedimentation rate are normal, the tuberculin test is negative, and the antistreptolysin O is within the normal range.

　　For patients with synovitis, it is recommended to consume more animal blood, eggs, fish, shrimp, soy products, potatoes, beef, chicken, and beef 'shank' meat, which are rich in histidine, arginine, nucleic acids, and collagen.

　　Secondly, it is advisable to eat less sweet food, as the sugar in it is prone to cause allergies and can exacerbate the development of synovitis, leading to increased joint swelling and pain. It is also recommended to limit the intake of alcohol and beverages such as coffee and tea, and to avoid passive smoking, as all these can worsen the progression of arthritis.

　　Again, eat less milk, goat's milk, and other dairy products, peanuts, chocolate, millet, cheese, sugar, and other foods containing tyrosine, phenylalanine, and tryptophan, as they can produce prostaglandins, leukotrienes, tyrosine kinase autoantibodies, and anti-milk IgE antibodies that cause arthritis, easily causing allergies and exacerbating arthritis, recurrence, or deterioration.

　　Finally, eat less fatty meat, high animal fat, and high cholesterol foods, as the ketone bodies, acids, arachidonic acid metabolites, and inflammatory mediators produced can inhibit the function of T lymphocytes, easily cause and worsen joint pain, swelling, bone demineralization, osteoporosis, and joint destruction, etc.

　　Traditional Chinese medicine treatment for transient synovitis can be performed by technique, and the combination of internal and external Chinese medicine is effective. Below is a specific introduction to the treatment of this disease in traditional Chinese medicine:

　　1. Massage and Manipulation

　　The patient lies on the bed with their hands crossed under their head. One assistant supports both elbows to prevent the hands from being pulled out from under the head; the operator stands on the healthy side, holding the ankle of the affected limb with one hand and the knee with the other. First, gently perform a hip and knee flexion test, and stop if pain occurs, performing extension and flexion movements of the two joints within the pain-free range. When the patient's muscles relax and they can actively cooperate with the movement, suddenly bend the hip and knee joints to the maximum extent, stay for 1 minute, and then perform the next step after the pain slightly subsides. That is, for longer legs, perform hip adduction and internal rotation of the affected limb, and for shorter legs, perform hip abduction and external rotation of the affected limb, then straighten the affected leg, and the technique is completed. After the patient's muscles are completely relaxed, both lower limbs can be of equal length, and the function can be restored. If it cannot be restored, the technique can be repeated once. After reduction, it is necessary to prevent the affected limb from external rotation and abduction, and try to rest in bed as much as possible.

　　For old injuries, after reduction, the two lower limbs should be brought together, and the upper part of the knee should be wrapped with a triangular bandage or cloth strip for 3 to 4 weeks to prevent the two legs from being separated. For new injuries, patients should avoid bearing weight and rest in bed.

　　2. Drug Treatment

　　For general new injuries, one can take an internal medicine formula for limb injuries with herbs to promote blood circulation and remove blood stasis. For old injuries, one can take a soup to relax tendons and muscles. For those with local pain, external application of a medicine plaster for removing blood stasis and relieving pain can be used.