FROM OUR EXPERTS
This question has not been answered by one of our experts yet.
In the previous post, we discussed different types of surgeries which are used in patients with rheumatoid arthritis . This week I’d like to talk more about surgeries involving soft-tissue, specifically synovectomy, tendon repair, and carpal tunnel release.
What is a Synovectomy?
The synonium is a membrane surrounded a joint, usually only one or two cell layers thick, which produces synovial fluid to help lubricate the joint. In rheumatoid arthritis, the synovium becomes inflamed and may grow excessively, producing too much synovial fluid containing an enzyme that can eat away at the cartilage on the joint surface. Disease-modifying anti-rheumatic drugs (DMARDs) are used to control the abnormal growth of synovium.
If DMARDs do not work, a patient’s rheumatologist may suggest steroid injections into a joint or a needle aspiration of excess synovial fluid. If these strategies do not work, then the patient may be referred to an orth...
Diagnosis Carpal tunnel syndrome is most accurately diagnosed using a medical history, the patient's descriptions of symptoms, a physical examination, and electrodiagnostic tests that measure nerve conduction through the hand. Diagnosing CTS, however, is not straightforward. Only a small fraction of patients exhibit all three factors necessary for a clear diagnosis: Classic CTS symptoms Specific physical findings Abnormal electrodiagnostic test results Many people have abnormal electrodiagnostic test results without classic symptoms or any symptoms at all. Furthermore, about 15% of the population has symptoms that are consistent with CTS, but in most of these people, test results do not indicate the disorder. MRI, CT scans, and other imaging tests are not useful for diagnosing carpal tunnel syndrome. Symptom Description and Severity Many cases of CTS result from a medical problem that is worsened by repetitive stress factors at work. The patient should give the doctor a detailed history and de...
Treatment It is critical to begin treating early phases of carpal tunnel syndrome before the damage progresses. A conservative approach to CTS, which may include corticosteroid injections and splinting, is the first step in treating this disorder. The conservative approach is most successful in patients with mild carpal tunnel syndrome. If the initial treatment doesn't improve symptoms in 2 - 7 weeks, another treatment or surgery should be tried. Some patients may start with surgery if there is evidence of nerve damage. Studies suggest that surgery is a better option for severe CTS. Surgery improves function and symptoms better than splinting or anti-inflammatory drugs plus hand therapy over the long term. The improvements last for more than 6 months. Even among patients with mild CTS, there is a high risk of relapse. Some researchers are reporting better results when specific exercises for carpal tunnel syndrome are added to the program of treatments. Limiting Movement. If possible, the ...
You should know
Answers to your question are meant to provide general health information but should not replace medical advice you receive from a doctor. No answers should be viewed as a diagnosis or recommended treatment for a condition. Content posted by community members does not necessarily reflect the views of Remedy Health Media, which also reserves the right to remove material deemed inappropriate.