Question submitted during Session I of The Arthritis Summit:
"Let's say you take radiographs and don't see an obvious problem. How can we determine if the animal has synovitis versus some other problem with the joint?"
- Answer provided by Dr. Marie Bartling:
That's a good question! Well, let me use "knee arthritis" as an example. Synovitis is the most common cause of knee arthritis in humans, dogs, and horses. Inflammation develops in the lining of the joint which is, by definition, synovitis. This results in the release of white blood cells and basically a cascading chemical reaction within the joint.
To address your question a little more specifically - let's look at cranial cruciate ligament (CCL) disease - which is very common. We can't visualize a CCL tear on radiographs. In some of these affected dogs we can see more of a synovitis and propagation of this bad chemistry within the joint. I often times perform an ultrasound - especially if I think the dog could have an early CCL tear. I want to get as much information as possible about what's happening inside of that joint. Sometimes the CCL itself can look pretty stable but the animal may have a synovitis which can be assessed by ultrasound.
The other way, of course, is by arthroscopy which Dr. Sawyere is going to talk more about during the Summit. We can essentially put a tiny camera into the joint and have a look around. We can actually visualize inflammation of the synovium or synovitis.
I recently had a chat about this with Dr. Sam Franklin. He is board certified in surgery as well as sports medicine and rehabilition. He shared some great perspectives on this and on related concepts:
