What is a pigment and winch? What are the symptoms of this disease? How treatment is carried out? Answers to these questions you will find in the article.
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What is a pigment and winch
Synovitis Pygmentosa Villiosa (Synovitis Pygmentosa Villiosa) - a disease characterized by proliferative-dysplanic lesion of the synovial shell of the joint of the synovial bags and synovial vaginas of tendons. Previously, it was described as a myeloxanthmant, xanthomante, myeloid endothelioma, Xantogrant, Fibrohemosidarous Sarcoma, a fibromus of tendon vagina. The most common in the domestic literature term «Pigment and Willese Sinovit», However, more accurately complies with the nature of the lesion (the abundance of the vigorous and nodules of brown-red brown-colored with separate yellow splashes;) Term «Pigmented Village-nodal Sinovit».
Synovitis Synovitis Pigment-Willomose
The first signs of the disease are usually randomly. Sometimes a minor injury contributes to their appearance. Paintyness of the affected joint, having a tough consistency, sometimes with separate latter inclusions, which slowly increases in size. It is accompanied by the formation of traffic, the amount of which, with the knee joint, reaches 200 ml, in the ankle and hip joints, its volume does not exceed 10 ml. A feature of the disease is to preserve the total volume of movements in the joint and normal gait, despite the significant sizes of swelling. Rarely meets the restriction of movements in the joint, peace or evacuation of fluid from the joint cavity contribute to the recovery of the amplitude of movements. One of the reasons for the late appeal to medical care is a small severity of pain syndrome. Pain in the joint occurs periodically, when driving, the intensity of it as the process progressing does not change. Pain in peace is observed in the defeat of the hip joint (hip synovit) with illness of 10 or more. A feature of the clinical flow is also the fact that despite the significant sizes of swelling, skin color and its venous drawing do not change. The noted increase in local temperature is associated with the pronounced vascularization of pathological tissue. Increased body temperature is not typical, although in some cases it is possible. With damage to large joints, patients often complain about discomfort in the joint and its blockade. Discomfort in the joint (sense of awkwardness, inconvenience) appears when changing positions and movements. This symptom is inconsistent, often it is detected only at the beginning and disappears as the disease progressing. The blockade of the joint is associated with the infringement of novels or naval structures. It appears suddenly when moving and eliminated after a few minutes, what is different from the blockade with another pathology, such as damage to the meniscus. The short-term blockade is due to the fact that the soft fabric of the fever or nodule growths is easily crushed. During the disease, three stages are distinguished. Stage I - initial manifestations: clinical signs are weakly pronounced, there are still no changes in radiographs, arthropneumograms and angiograms. Stage II is characterized by the fact that in addition to clinical symptoms, changes in radiographs are already determined in the form of an increase in the volume of soft tissues and their seals and typical changes on arthropneumograms and angiograms. III Stage - Late, differs from the previous presence of foci of destruction in the bones.
Treatment of pigment-winged synovit
One of the varieties of clinical course of the disease is a tumor form of the disease. It is rare, characterized by the appearance of a dense buggy tumor, foci of occurrence of a soft-walled component, enhancing the venous skin pattern, and anemia, a decrease in body weight of the patient notes.
The choice of treatment method depends on the form of the disease. With local form, the operation is carried out - partial synovkapsulectomy (excision of a limited section of the capsule, including its synovial and fibrous layers). With diffuse uniform, regardless of the stage use combined treatment. At its first stage, surgery is carried out - total synovkapsulectomy, on the second - radiation therapy. When the knee joint synotes simultaneously remove both meniscus, t.To. His rear horns are intimately connected with a fibrous capsule, and the front prevents the complete removal of synovial fabric in the region of the external and internal soils of the tibia. The goal of radiation therapy is the effect on the synovial tissue of transition zones (the area of the articular surfaces of the bones, where altered synovial cells remain), as well as on the pathological tissue, which can remain in the lumen of nutrients, at different depths in the bone tissue. Rauchery therapy is carried out in radiological offices after 3 weeks. after operation. The boundaries of irradiation fields should correspond to the preoperative stretching of the joint capsule or somewhere to exceed it. One-time dose 1.5-2.0 gr, total - 18-19 grams. In those rare cases when there is a pathological tissue output beyond the limits of a fibrous capsule (possibly with a long existence of the disease), the total focal dose increases to 21-23 gr. During the exposure period, the hardening mode is preserved and the patients continue to do.
One of the most important tasks of the postoperative period is the restoration of the mobility of the joint. To this end, from the 2nd day after operation, patients proceed to isometric muscle tensions, and from the 5th day - to active movements in the affected joint. Development is carried out during the day, in addition, the laying is prescribed in the position of the maximum flexion or extension. Within 1.5-2 months. After the operation, the unloading mode is prescribed, the patients are moved only with the help of crutches, then gradually go to walking with a cane.
The use of combination treatment allows you to avoid recurrence of the process and get a satisfactory functional result.
