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In a small number there is an abundant serous exudate, and with this there may be a considerable formation of fibrin, covering the surface of the membrane and floating in the fluid as flakes or masses; under the influence of movement it may assume the shape of melon-seed bodies. More rarely the joint contains pus, and the surface of the synovial membrane resembles the wall of a cold abscess.
#Definition of Terms.# The term synovitis is applied to any reaction which affects the synovial membrane of a joint. It is usually associated with effusion of fluid, and this may be serous, sero-fibrinous, or purulent.
This is followed by the injection of a quantity of seventy-five percent alcohol and the wound is dressed and bandaged as already described. At each subsequent dressing of infected wounds so treated less suppuration is noticed and the synovial discharge usually ceases in from one to two months.
Joint lesions are comparatively common in #scarlet fever#, and were formerly described as scarlatinal rheumatism. The most frequent clinical type is that of a serous synovitis, occurring within a week or ten days from the onset of the fever. Its favourite seat is in the hand and wrist, the sheaths of the extensor tendons as well as the synovial membrane of the joints being involved.
Reference is here made to the chronic inflammations of the synovial membrane of joints, of tendon sheaths and of bursæ chronic synovitis, teno-synovitis and bursitis; of the fibrous tissues of joints chronic forms of arthritis; of the blood vessels chronic forms of endarteritis and of phlebitis and of the peripheral nerves neuritis.
The most important ones are the skin, which covers the entire external surface of the body; the mucous membrane, which lines all the cavities that communicate by openings with the external surface; and the serous membrane, which, including the synovial membranes, lines all the closed cavities of the body.
An acute inflammation of a small bursa may even result in the destruction of such synovial apparatus without serious inconvenience to the subject, either at the time of destruction or thereafter. Obliteration of the superficial bursa over the summit of the os calcis is not likely to cause serious inconvenience or distress to the subject unless it be due to an infected wound.
Synovial distension of tendon sheaths and bursae in the region of the fetlock are caused by the same active agencies which produce this condition in other parts. The fetlock region is exposed to more frequent injury than is the carpus and as a consequence is more often affected.
The commonest type is a chronic synovitis or hydrops, in which the joint very often the knee becomes filled with a serous or sero-fibrinous exudate. There are no reactive changes in the synovial membrane, cellular tissue, or skin, nor is there any fever or disturbance of health. The movements are free except in so far as they are restricted by the amount of fluid in the joint.
The changes in the joints involve almost exclusively the synovial membrane and the ligaments; they consist in cellular infiltration and exudation, resulting in the formation of new connective tissue which encroaches on the cavity of the joint and gives rise to adhesions, and by contracting causes stiffness and deformity.
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