ANKLE SYNOVITIS |
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General Information
DEFINITION--Inflammation of the synovium, the smooth, lubricated lining of the ankle joint. The synovium's lubricating fluid helps the ankle move freely and prevents bone surfaces from rubbing against each other. Synovitis is often a complication of an injury, such as a fracture, or of collagen diseases, such as gout or rheumatoid arthritis.
BODY PARTS INVOLVED
Ankle joint.
Synovial membrane surrounding the entire joint.
Space between the joint and the synovial membrane.
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SIGNS & SYMPTOMS
Pain and heat in the ankle.
No visible ankle swelling. Swelling and fluid accumulation is deep within the joint.
CAUSES
Any injury to the ankle and ankle joint.
Bacterial infection (frequently gonorrhea).
Metabolic disturbance, such as an acute attack of gout or rheumatoid arthritis.
RISK INCREASES WITH
Repeated ankle injury.
Poor muscle strength or conditioning, which makes ankle injury more likely.
Inadequate ankle strapping prior to participation in contact sports.
Medical history of gout, rheumatoid arthritis, or other inflammatory joint diseases.
Infection in another joint.
Vitamin or mineral deficiency, which makes complications following injury more likely.
HOW TO PREVENT
Tape the ankle securely from midfoot to midcalf before participation in contact sports. If taping is not possible, wear supportive elastic ankle wraps.
Protect the ankle with substantial support during sports activities for 12 months after a significant ankle injury.
WHAT TO EXPECT
APPROPRIATE HEALTH CARE
Doctor's diagnosis and application of a walking cast and tape.
Self-care during rehabilitation.
Whirlpool, ultrasound or massage to displace excess fluid from the injured joint space.
DIAGNOSTIC MEASURES
Your own observation of symptoms.
Medical history and exam by a doctor.
X-rays of the ankle, foot and knee to rule out fractures.
POSSIBLE COMPLICATIONS
Prolonged healing time if activity is resumed too soon.
Proneness to repeated ankle injury.
Unstable or arthritic ankle joint following repeated bouts of synovitis.
Chronic synovitis that may prevent athletic participation.
PROBABLE OUTCOMEHealing is possible in 3 to 5 weeks with heat treatments, corticosteroid injections and rest (of the ankle). In many cases, ankle synovitis does not heal completely and becomes chronic. This is because the ankle joint is subjected to continual stress.
HOW TO TREAT
NOTE -- Follow your doctor's instructions. These instructions are supplemental.
FIRST AIDNo first aid. This condition develops gradually.
CONTINUING CARE
Obtain treatment for any underlying medical condition, such as gout or infection.
For greater comfort, keep the foot elevated whenever possible.
You may need a walking plaster boot cast for 10 to 14 days. See Appendix 2, Care of Casts.
After the cast is removed, apply heat frequently. Use heat lamps, hot soaks, hot showers, heating pads, or heat liniments and ointments.
Take whirlpool treatments, if available.
Massage gently and often to provide comfort and decrease swelling.
Chronic synovitis may require ankle strapping before any workout or competition.
MEDICATION
Your doctor may prescribe:
Antibiotics if infection is present.
Non-steroidal anti-inflammatory drugs or antigout medicine.
Injection of a long-acting local anesthetic mixed with a corticosteroid to help reduce pain and inflammation.
You may take aspirin or ibuprofen for minor discomfort.
ACTIVITYResume normal activities slowly as swelling, pain, redness and disability diminish.
DIETDuring recovery, eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Increase fiber and fluid intake to prevent constipation that may result from decreased activity. Your doctor may suggest vitamin and mineral supplements to promote healing.
REHABILITATION
Rest the ankle for 3 to 5 weeks. Elevate it whenever possible.
Begin daily rehabilitation exercises when a walking cast is no longer needed.
Use ice massage for 10 minutes before and 10 minutes after exercise. Fill a large Styrofoam cup with water and freeze. Tear a small amount of foam from the top so ice protrudes. Massage firmly over the injured area in a circle about the size of a baseball.
See section on rehabilitation exercises.
CALL YOUR DOCTOR IF
You have symptoms of ankle synovitis.
Symptoms worsen or persist longer than 5 weeks despite treatment outlined above.
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