Distal Synovitis

The examination of explanted devices noted significant yarn-yarn abrasion at the distal end of the implant and at anchorage sites as well as yarn-bone abrasion at the exit of the tunnels. Moreover, it initiates an inflammatory reaction in the knee, causing effusion and synovitis, and delaying maturation of the autogenous graft and it may be associated with an increased risk of infection. Its routine use is no longer recommended. ... 

Fig. 8.71a,b. Synovitis of the elbow joint pitfall. a,b Transverse 12-5 MHz US images over the posterior olecranon recess a in a normal subject and b in a patient with rheumatoid arthritis and an olecranon recess (arrows) appears markedly distended by fluid. In a, the normal hypoechoic fat contained. In b the olecranon fossa, between the lateral (LE) and medial (ME) epicondyles, should not be confused with the synovitis process shown in b. In doubtful cases, careful dynamic examination with elbow flexion and extension movements may be helpful for the diagnosis. Note the erosion (arrowhead) on the posteromedial aspect of the lateral epicondyle. T, distal triceps tendon... 

Fig. 10.66a,b. Distal radio-ulnar joint synovitis, a Distal and b proximal transverse 12-5 MHz US images obtained over the dorsal aspect of the distal radio-ulnar joint at the levels horizontal black bars) indicated in the diagram on the left show the proximal recess distended by fluid (arrows). No effusion is seen at the level of the articular cartilages. The inserts at the upper right sides of the figure indicate probe positioning... 

Fig.l6.86a-c. Synovitis of the ankle joint anterior recess, a Mid-sagittal 12-5 MHz US image over the dorsal ankle in a patient with joint effusion reveals a distended anterior joint recess (arrows) filled with hypoechoic fluid between the hyperechoic margins of the distal epiphysis of the tibia (star) and the talar head (asterisk). b Lateral radiograph reveals increased density (arrows) involving the anterior ankle, consistent with a synovial process, c The patient presented with anterior swelling (curved arrow) of the ankle... 

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