Introduction
Synovitis is a health problem where the lining of the joints gets swollen and inflamed. This inflammation can make different joints hurt, swell, feel stiff, and make it hard to move them. Synovitis can happen for different reasons like autoimmune problems, infections, physical injuries, or using joints too much.
What Is Finger Joint Synovitis?
The finger joints comprise bones, ligaments, tendons, and a special covering called the synovial membrane. A finger is made up of three bones. The proximal phalangeal and middle phalangeal bones are connected by a joint called the proximal interphalangeal joint (PIP), and the middle phalangeal and distal phalangeal bones are separated by a joint called the distal interphalangeal joint (DIP). When these bones meet, cartilage and a capsule around the bone ends to protect them.
This capsule has a layer inside called the synovial membrane. It holds synovial fluid, which helps the joint move smoothly and keeps the cartilage healthy. It also helps to prevent rubbing and grinding of the joint. Synovitis/capsulitis results from inflammation within the joint capsule, often presenting as noticeable swelling in the finger joints. Finger joint synovitis is a health issue distinguished by the swelling of the synovial membrane that encases the finger joints.
What Causes Finger Joint Synovitis?
Several factors can contribute to the development of finger joint synovitis:
Inflammatory Conditions
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Rheumatoid Arthritis - This autoimmune disease is a common cause of finger joint synovitis, leading to chronic inflammation and joint damage.
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Psoriatic Arthritis - People with psoriasis may develop psoriatic arthritis, which can affect the finger joints, leading to synovitis.
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Systemic Lupus Erythematosus - SLE is another autoimmune condition that can cause inflammation in the finger joints.
Infection
- Bacterial or fungal infections can lead to septic arthritis, an acute form of joint inflammation that may affect finger joints.
Mechanical Factors
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Trauma - Direct injury to the finger joint, such as fractures or dislocations, can trigger synovitis.
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Overuse - Repeated and excessive stress on the finger joints, as seen in some occupational activities, can lead to synovitis. Activities that commonly cause finger joint synovitis include typing, playing musical instruments, climbing, and repetitive gripping tasks.
What Are the Symptoms of Finger Joint Synovitis?
Finger joint synovitis can manifest with a range of symptoms, including:
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Persistent pain in one or more finger joints, often worsened by movement.
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Swelling and puffiness around the affected joints may be warm to the touch.
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Early-morning finger stiffness.
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Limited mobility in the fingers that are affected, posing difficulty in achieving full bending or straightening.
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Tenderness or sensitivity at the joint site.
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The skin covering the impacted joint may exhibit signs of redness and inflammation.
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Increased heat around the affected joint due to increased blood flow and inflammation.
How Is Finger Joint Synovitis Diagnosed?
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The healthcare provider will assess the affected finger joints, looking for signs of inflammation, pain, and limited mobility.
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Information about the medical history, including any autoimmune conditions, recent injuries, or infections, will be important in the diagnostic process.
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X-rays, ultrasounds, or MRI scans may be ordered to visualize the affected joints and assess for any structural damage.
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Blood tests can help identify markers of inflammation, autoimmune conditions, or infections, aiding in the diagnosis.
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In some cases, a joint fluid aspiration (removing a small amount of synovial fluid) may be performed to analyze the fluid for signs of infection or inflammation.
What Are the Treatment Options for Finger Joint Synovitis?
Treatment for finger joint synovitis depends on the symptoms' underlying cause and severity. The following approaches may be considered:
Medications
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NSAIDs are given to help with the inflammation and pain.
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Disease-modifying anti-rheumatic drugs are given for autoimmune-related finger joint synovitis. This helps in slowing down the progression of the disease.
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Corticosteroid injections into the affected joint can temporarily relieve inflammation and pain.
Physical Therapy
- Physical therapy might be advised to enhance joint flexibility, increase strength, and assist in pain control.
Rest and Immobilization
- For cases of acute synovitis due to trauma, rest and immobilization of the affected finger may be necessary to allow healing. Finger arthritis sleeves can be purchased to immobilize the affected area.
Surgical Interventions
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In severe synovitis or infection cases, joint aspiration and lavage may be performed to remove excess synovial fluid and debris.
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Surgical interventions like joint replacement or joint fusion may be necessary in advanced cases of finger joint synovitis with joint damage.
How Is Rehabilitation of Finger Joint Synovitis Done in Climbers?
Climbing is a physically demanding and exhilarating sport that places unique stresses on the finger joints and hands. The repetitive gripping, crimping, and dynamic movements can lead to various climbing finger injuries, including joint synovitis. The proximal interphalangeal joint is commonly affected in climbers, leading to PIP synovitis.
The common strategies of rehabilitation include the following.
Phase 1 (First 2 Weeks)
- Unloading Techniques - To relieve strain on the finger joint, a regimen of icing the finger for 5 minutes (using either an ice bucket or a cold compressive gel pack) once daily can be done.
- Compression Bandage - The finger should be wrapped in a self-adherent compression bandage wrap or floss band.
- Active Range of Motion - Active range of motion exercises can be performed thrice daily for 45 seconds each.
Phase 2 (6 Weeks Duration)
- Mobility Exercises - Daily mobility exercises can be introduced, involving three sets of 45 seconds each. Some common exercises include oscillatory PIP joint mobilizations (using a finger trap to separate joint surfaces and thumb support to block the middle phalanx), instrument-assisted soft tissue mobilization of the fingers with moderate pressure, and active straight fingers to hook the first range of motion.
- Strength Training - Strength exercises can be done, including rubber band flicks and palmar interosseous gripping exercises.
- Transition to Reduced Frequency - After 6 weeks, the frequency of mobility and strength exercises can be reduced from daily to three times per week.
Conclusion
While finger joint synovitis can be challenging and sometimes painful. People can effectively manage and even overcome this condition if diagnosed early, treated properly, and diligently rehabilitated. The progress in medical knowledge, along with the dedication of doctor and patients, give hope for a good result. Taking steps to prevent hand and finger health problems and being proactive can greatly lower the chances of getting synovitis in the first place.
