What Is Synovitis?
Synovitis indicates inflammation in the lining of the joint, or synovium. Synovitis is characterized on physical examination by swelling, redness, and warmth.
What Is Subclinical Synovitis?
Subclinical synovitis is inflammation of the lining of the joint that is not found during a physical exam but patients may complain of joint pain and prolonged morning stiffness.
Diagnosing and Treating Synovitis
Newer techniques such as MRI scanning may detect subclinical synovitis. The clinical significance of these MRI findings are unclear at this time. In my experience as a rheumatologist, patients with subclinical synovitis and normal measures of inflammation in the blood (erythrocyte sedimentation rate or ESR, and C-reactive protein or CRP) are unlikely to develop joint damage that shows up on basic X-rays, although I am not aware of any published studies on this subject.
The important point is that there are patients with active rheumatoid arthritis who do not have the typical swollen joints but may have quality of life issues based on their symptoms, requiring treatment including methotrexate and TNF blockers (i.e. Enbrel, Remicade, or Humira).
Answers provided by Scott J. Zashin, M.D., clinical assistant professor at University of Texas Southwestern Medical School, Division of Rheumatology, in Dallas. Dr. Zashin is also an attending physician at Presbyterian Hospitals of Dallas and Plano. He is a fellow of the American College of Physicians and the American College of Rheumatology and a member of the American Medical Association. Dr. Zashin is author of Arthritis Without Pain - The Miracle of TNF Blockers. The book is useful for anyone on one or considering the biologic drugs (Enbrel, Remicade, Humira). Read our review of the book.
