Synovitis Of Knee Joint Research Articles

Effect of weight loss on knee joint synovitis over 48 months and mediation by subcutaneous fat around the knee: data from the Osteoarthritis Initiative

BackgroundObesity influences the development of osteoarthritis via low-grade inflammation. Progression of local inflammation (= synovitis) increased with weight gain in overweight and obese women compared to stable weight. Synovitis could be associated with subcutaneous fat (SCF) around the knee. Purpose of the study was to investigate the effect of weight loss on synovitis progression and to assess whether SCF around the knee mediates the relationship between weight loss and synovitis progression.MethodsWe included 234 overweight and obese participants (body mass index [BMI] ≥ 25 kg/m2) from the Osteoarthritis Initiative (OAI) with > 10% weight loss (n = 117) or stable overweight (< ± 3% change, n = 117) over 48 months matched for age and sex. In magnetic resonance imaging (MRI) at baseline and 48 months, effusion-synovitis and Hoffa-synovitis using the MRI Osteoarthritis Knee Score (MOAKS) and average joint-adjacent SCF (ajSCF) were assessed. Odds-ratios (ORs) for synovitis progression over 48 months (≥ 1 score increase) were calculated in logistic regression models adjusting for age, sex, baseline BMI, Physical Activity Scale for the Elderly (PASE), and baseline SCF measurements. Mediation of the effect of weight loss on synovitis progression by local SCF change was assessed.ResultsOdds for effusion-synovitis progression decreased with weight loss and ajSCF decrease (odds ratio [OR] = 0.61 and 0.56 per standard deviation [SD] change, 95% confidence interval [CI] 0.44, 0.83 and 0.40, 0.79, p = 0.002 and 0.001, respectively), whereas odds for Hoffa-synovitis progression increased with weight loss and ajSCF decrease (OR = 1.47 and 1.48, CI 1.05, 2.04 and 1.02, 2.13, p = 0.024 and 0.038, respectively). AjSCF decrease mediated 39% of the effect of weight loss on effusion-synovitis progression.ConclusionsEffusion-synovitis progression was slowed by weight loss and decrease in local subcutaneous fat. Hoffa-synovitis characterized by fluid in the infrapatellar fat pad increased at the same time, suggesting a decreasing fat pad rather than active synovitis. Decrease in local subcutaneous fat partially mediated the systemic effect of weight loss on synovitis.

Role of Ayurveda in the management of Post-traumatic chronic inflammatory synovitis of knee joint- A Case Report

Knee is a complex joint. It is the most commonly injured joint in the body. Trauma may injure soft tissues such as ligaments or bones of the joint. Inflammatory synovitis is one of the conditions developed after trauma. This article encompasses a diagnosed case of Post traumatic chronic inflammatory synovitis. Treatment protocol was opted considering its samprapti (Pathophysiology) as janu sandhi marmaghata. Treatment was planned considering Sandhi marmaghata. Symptomatic treatment was also considered. Significant improvement was observed in parameters like range of motion, knee joint circumference, walking distance and VAS scale within a week. No recurrence observed even after 1 year of suspended treatment. This multimodular Ayurveda treatment appears to be safe and efficient for early recovery and better outcomes.

Prospective Comparison of the Imaging Value of 99m Tc-MDP Bone Scan and 68 Ga-FAPI-04 PET/CT in Synovitis, Acne, Pustulosis, Hyperostosis, and Osteitis Syndrome.

This study aimed to explore the imaging value of 68 Ga-FAPI-04 PET/CT in synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome and compare it with that of 99m Tc-MDP bone scan. Nineteen participants with SAPHO syndrome underwent 68 Ga-FAPI-04 PET/CT and 99m Tc-MDP bone scan. Demographic data and clinical features were recorded, SAPHO imaging features were analyzed, and the osteoarticular lesion detection rate in both methods was calculated. This prospective study recruited 4 men and 15 women aged 52.4 ± 8.6 years. The anterior chest wall was involved in all participants (100%). Palmoplantar pustulosis was the most common (36.8%) skin symptom. 99m Tc-MDP bone scan and 68 Ga-FAPI-04 PET/CT together detected 84 osteoarticular lesions, of which 91.7% (77/84) were detected by the former and 96.4% (81/84) by the latter. Furthermore, 68 Ga-FAPI-04 PET/CT detected 5 cases of knee and hip joint synovitis. 68 Ga-FAPI-04 PET/CT was more sensitive than 99m Tc-MDP bone scan when evaluating osteoarticular lesions in SAPHO syndrome and could also evaluate synovial lesions. 68 Ga-FAPI-04 PET/CT could be a good imaging method for SAPHO syndrome but requires further verification in a more extensive research cohort.

RARE CASE OF BILATERAL TUBERCULAR SYNOVITIS OF THE KNEE JOINT.

Aim-To describe rare case of Bilateral tubercular synovitis of the knee joint. Musculoskeletal involveme Background- nt in tuberculosis is seen in about 19 % of the case. Joint Tuberculosis is a disease of usually one joint. Although pulmonary Tuberculosis may be absent,patients may present with symptoms of anorexia, weight loss, evening rise of temperature even in extra-pulmonary tuberculosis. 30 yr old male patient presented with acute onset bilateral Case Descriptiontubercular synovitis of both knee joints. The Acid fast bacilli was isolated from both knee joints. Histopathology examination of the synovium did not show tubercular granuloma. However Gene Xpert of the sample showed low grade tuberculosis which was sensitive to rifampicin. Hence this is a rare case in itself,as such case presentation for tuberculosis has not yet been described in the literature. Bilateral tubercular knee joint synoviti Conclusion- s with systemic symptoms of tuberculosis can be rare case presentation of tuberculosis. Bilateral Clinical Significancetubercular knee synovitis can be one of the differential diagnosis of bilateral knee synovitis

Therapeutic Effect of Warm Acupuncture on Traumatic Synovitis of Knee Joint in 21 Cases

Purposes: To observe the clinical efficacy of warm acupuncture in the treatment of knee synovitis. Methods: A total of 42 patients with traumatic synovitis of the knee joint were randomly divided into a control group and a treatment group, 21 cases in each group. The control group was treated with common acupuncture combined with TDP local irradiation, and the treatment group was treated with moxa cone wen acupuncture on the basis of common acupuncture. Results: Control group effectiveness: 90.5%, treatment group efficiency is 95.2%, between the two groups there is a comparative significant difference (p&lt;0.05), treatment group pain score improvement and joint activity improvement is superior to the control team, with statistical significance (p &lt;.05). Conclusion: The treatment of joint synovitis by warm acupuncture in control group and treatment group was more effective in alleviating knee pain and improving functional activities than acupuncture alone.

Non-pigmented villonodular synovitis of knee joint in a 11-year-old boy on long term steroids: a case report

&lt;p&gt;Pigmented villonodular synovitis (PVNS) is a rare condition, commonly affecting the knee joint and hip joint. It is seldomly seen in pediatric age group. Aetiology is unknown. Magnetic resonance imaging (MRI) is the imaging modality of choice. Managed by surgical resection of the synovium performed with an open, arthroscopic or combined approach. Post-operative adjuvant external beam radiotherapy have reduced recurrence rate. In this case report we are going to present a rare case of eleven-year-old boy on long term steroid intake, who presented with a history of pain and swelling of right knee joint with restriction of range of movements. MRI suggested extensive villonodular synovitis of knee joint. Diagnostic arthroscopy showed extensive villonodular synovitis of suprapatellar pouch, medial gutter, lateral gutter, intercruciate space, posterior-medial and posterior-lateral compartments and villi had atypical yellow fatty appearance. Extensive arthroscopic synovectomy was done and histopathology showed chronic synovitis. Post-operatively pain and swelling reduced and range of movements improved. Arthroscopic synovectomy is the most effective line of management for villonodular synovitis.&lt;/p&gt;

Сурфактантное состояние синовиальной жидкости у больных ревматоидным гонитом

По сравнению с больными остеоартрозом со вторичным синовитом коленных суставов (контрольная группа) при ревматоидном гоните наблюдается уменьшение содержания в синовиальной жидкости общего белка, нитритов, мочевой и молочной кислоты на фоне повышения уровней глюкозы и С-реактивного протеина, причем на интегральное сурфактантное состояние синовии влияют степень активности и рентгенологическая стадия заболевания, наличие дигитального артериита и поражения эндокарда. Кроме того содержание общего белка и β2-микроглобулина зависит соответственно от индексов тяжести течения и прогрессирования заболевания, а с поверхностно-активными веществами тесно связаны динамическое межфазное натяжение, вязкие, упругие и вязкоэластичные адсорб­ционно-реологические свойства суставного ликвора.

Pigmented villonodular synovitis of knee joint: A case report

Pigmented villonodular synovitis of knee joint: A case report

Pigmented villonodular synovitis of knee joint: A case report

Diffuse type tenosynovial giant cell tumor (D-TGCT) is a locally aggressive benign proliferation. Knee joint is the most commonly affected site. We present a case report with a 16 months follow up after recurrent surgery and postoperative radiotherapy.

Ultrasound Evaluation of Three Outcome Domains in the Follow-up of Urate-Lowering Therapy in Gout: An Observational Study

This prospective study was aimed at observing the changes in three ultrasound (US) outcome domains (urate deposition, joint inflammation and bone erosion) in gout patients within the 1 y on urate-lowering therapy. The elementary lesions, including tophus, double-contour (DC) sign, aggregates, synovitis and bone erosion of the bilateral knee, ankle and first metatarsophalangeal joints, were evaluated repeatedly by US before and after 3, 6 and 12 mo of treatment, and the effective rates of clearance of tophus, DC sign and aggregates in different time groups were compared. A Global OMERACT–EULAR Synovitis Score (GLOESS) was calculated for these three paired joints to observe the inflammation. Bone erosion was also scored. The correlation between serum uric acid levels and tophus size changes was analyzed. Our results indicated that the decrease in serum uric acid levels was not completely parallel to the decrease in tophus size. For tophus, there was no significant difference in the clearance rate between different time groups (χ2 = 1.76, p = 0.392), while for DC sign and aggregates, there were significant differences (χ2 = 21.48, p < 0.001, χ2 = 7.75, p = 0.018). Meanwhile, GLOESS was significantly lower after 6 mo of therapy (χ2 = 32.316, p < 0.001). Additionally, bone erosion had not improved after 1 y of treatment (Z = –1.633, p = 0.102). Thus, US is crucial for assessing response to urate-lowering therapy in gout.

Value of Contrast-Enhanced Ultrasonography in Evaluating Rheumatoid Arthritis: Preliminary Research Based on an Animal Model.

BackgroundThe aim of this study was to evaluate the effectiveness of grayscale ultrasound (GSUS), power Doppler imaging (PDI), and contrast-enhanced ultrasonography (CEUS) in early rheumatoid arthritis (RA) diagnosis through animal experiments.Material/MethodsA rabbit RA model was constructed. The animals were randomly divided into 2 groups, namely, the RA model group and the control group. GSUS, PDI, and CEUS were performed in the model group during early RA and were compared with pathology of synovial biopsies. The consistency of 3 types of ultrasonography was evaluated in tandem with pathological grading.Results23 rabbits in the RA model group completed the experiment. GSUS showed that the synovial thickening of grades 1, 2 and 3 occurred in 12, 19, and 15 joints, respectively. The sensitivity, specificity, and accuracy of PDI in the diagnosis of knee joint synovitis in RA grades 1, 2, and 3 were 80.56% (29/36), 60.00% (6/10), and 76.09% (35/46), respectively, while those with CEUS were 94.44% (34/36), 90.00% (9/10), and 93.47% (43/46), respectively. The differences in diagnostic sensitivity, specificity, and accuracy of the 2 methods were statistically significant. Additionally, the thickness of the synovium measured with GSUS precontrast was greater than that of postcontrast.ConclusionsRA evaluated with GSUS is often more hypertrophied than when evaluated with CEUS, while evaluation by PDI is less hypertrophied than that by CEUS. However, from a practical view point, GSUS and PDI are of sufficient practical value, except for in a few special cases.

Assessment of knee joint synovitis at ultra-high field (7T) MRI: a multi-dimensional approach using contrast-enhanced and non-enhanced sequences

Purpose: With clearance for clinical use recently, 7T systems are already used clinically and will potentially become more widely available. MRI has made an important clinical impact in the assessment of inflammatory arthritis and osteoarthritis in the last decade. However, to date no clinical studies are available that have assessed the feasibility of 7T MRI for evaluation of inflammatory structural features of arthritis. Recommended imaging protocols on standard 1.5T and 3T systems include T1- and T2-weighted fat suppressed spin echo sequences and the use of contrast-enhanced (CE) MRI for the evaluation of synovitis.

Comprehensive assessment of knee joint synovitis at 7\u2009T MRI using contrast-enhanced and non-enhanced sequences

BackgroundSeven T ultra-high field MRI systems have recently been approved for clinical use by the U.S. and European regulatory agencies. These systems are now being used clinically and will likely be more widely available in the near future. One of the applications of 7 T systems is musculoskeletal disease and particularly peripheral arthritis imaging. Since the introduction of potent anti-rheumatic therapies over the last two decades MRI has gained increasing importance particularly for assessment of disease activity in early stages of several rheumatic disorders. Commonly gadolinium-based contrast agents are used for assessment of synovitis. Due to potential side-effects of gadolinium non-enhanced techniques are desirable that enable visualization of inflammatory disease manifestations. The feasibility of 7 T MRI for evaluation of peripheral arthritis has not been shown up to now. Aim of our study was to evaluate the feasibility of contrast-enhanced (CE) and non-enhanced MRI at 7 T for the assessment of knee joint synovitis.MethodSeven T MRI was acquired for 10 patients with an established diagnosis of psoriatic or rheumatoid arthritis. The study pulse sequence protocol was comprised of a sagittal intermediate-weighted fat-suppressed (FS), axial fluid-attenuated inversion recovery (FLAIR) FS, sagittal 3D T1-weighted dynamic contrast enhanced (DCE) and an axial static 2D T1-weighted FS contrast-enhanced sequence (T1-FS CE). Ordinal scoring on non-enhanced (Hoffa- and effusion-synovitis) and enhanced MRI (11-point synovitis score), and comparison of FLAIR-FS with static T1-FS CE MRI using semiquantitative (SQ) grading and volume assessment was performed. For inter- and intra-reader reliability assessment weighted kappa statistics for ordinal scores and intraclass correlation coefficients (ICC) for continuous variables were used.ResultsThe total length of study protocol was 15 min 38 s. Different amounts of synovitis were observed in all patients (mild: n = 3; moderate: n = 5; severe: n = 2). Consistently, SQ assessment yielded significantly lower peripatellar summed synovitis scores for the FLAIR-FS sequence compared to the CE T1-FS sequence (p < 0.01). FLAIR-FS showed significantly lower peripatellar synovial volumes (p < 0.01) compared to CE T1-FS imaging with an average percentage difference of 18.6 ± 9.5%. Inter- and intra-reader reliability for ordinal SQ scoring ranged from 0.21 (inter-reader Hoffa-synovitis) to 1.00 (inter-reader effusion-synovitis). Inter- and intra-observer reliability of SQ 3D-DCE parameters ranged from 0.86 to 0.99.ConclusionsSeven T FLAIR-FS ultra-high field MRI is a potential non-enhanced imaging method able to visualize synovial inflammation with high conspicuity and holds promise for further application in research endeavors and clinical routine by trained readers.

The results of 394 consecutive cases of knee joint radiation synovectomy (radiosynoviorthesis) using 90Y.

The aim of this study was to assess the treatment results of 90Y radiation synovectomy for chronic exudative synovitis of knee joints. The retrospective data consist of 394 consecutive knee radiation synovectomies performed using 6mCi (222MBq) of 90Y. The assessment included 3-point custom pain and joint mobility scale, evaluation of joint's circumference, binary joint's temperature evaluation, patellar ballottement test, indications for puncture and its volume in applicable cases. 21 cases had to be forfeited due to missing data regarding follow-up. The final analysis of 373 treatment procedures performed in 253 patients yielded following results-at 6months after treatment, 80.9% of the patients reported at least partial pain relief (including 33.3% with complete pain relief), which increased to 86.7% at one year. The pain intensity decreased over time, however, the outcomes were worse in older patients. The probability of pain recurrence was 15% at 6months, and 28% at one year. It was highest in post-traumatic synovitis, and lowest in pigmented villonodular synovitis. The circumference of the treated knee joints decreased over the course of follow-up, however, the decrease was significantly lower in older patients. The fraction of patients with full knee joint mobility increased from 34.6 to 40.6% at 6months and 49.2% at one year. The percentage of patients that required articular puncture decreased from 62.8% at baseline to about 35.6% at 6months, and 32.8% at one year. Positive patellar ballottement was found in 68.5% before treatment and remained at about 40-50% during the course of follow-up. The increased temperature of the joint was reported in 51.2% at baseline and decreased to 33% at 6months and 28.3% at one year. (1) Radiation synovectomy is a safe and effective method of treatment in patients with exudative synovitis, however, the pain recurrence rate is significantly higher in post-traumatic exudative synovitis compared to pigmented villonodular, undifferentiated, and rheumatoid arthritis. (2) Our results suggest that older patients have worse treatment results with radiation synovectomy compared to younger patients.

Investigation of protein content of synovial fluids with DSC in different arthritides

In the case of joint diseases, as a result of the process induced by the pathophysiological factors, the small articular structures that have pilled result in a qualitative and quantitative modification of the composition of the synovial fluid (SF). The analysis of this fluid offers a unique opportunity to study the joint diseases. In our study, 28 cases of acute knee joint meniscus injuries, transient knee joint synovitis, or degenerative knee joint destruction were studied. Following the collection and storage of SF, removed on the basis of the sample collection protocol, they were denatured in a SETARAM Micro DSC-II calorimeter with a scanning rate 0.3 K min−1 in the 20–90 °C temperature range. 4–4 samples from the “normal” SF batch were inoculated by two different strains of bacteria [Staphylococcus aureus and Staphylococcus epidermidis] with 10−3 colony-forming unit. Thermoanalytical changes of the proteins found in the SF were studied by a SETARAM Micro DSC-II, in the laboratory of the Biophysical Institute. The maximum denaturation temperature of the proteins being in the SF with different severity varied according to the criterion of the radiological scaling of osteoarthritis made by the Kellgren–Lawrence criterion. The decomposition of the scans showed the degree of the damage in case of SF as well as in the inoculated samples. Knowing the denaturing properties of temperature-dependent protein molecules in SF, DSC can be used to design and develop intra-articular lubricant additives that effectively enhance protein stability and contribute to a reduction in joint wear.

Correlation between systemic markers of inflammation and local synovitis in knee osteoarthritis.

Background:In the elderly population joint swelling, effusion and pain indicate local synovitis and the presence of inflammation. At present, no serum marker has been shown linking to knee synovitis in KOA. With regard to serum high sensitive C-reactive protein (hsCRP) as a measure of inflammation, this study aimed to determine the association of systemic inflammation with local synovitis, as well as with pain and muscle strength in KOA.Methods:The study population was selected consecutively among patients with KOA presented to Ayatollah Rouhani Hospital Rheumatology Clinic with knee joint synovitis. The diagnosis of KOA was confirmed according to the American College of Rheumatology diagnostic criteria. Data regarding radiographic, demographic and biochemical characteristics were provided and IL-17, IL-10, TGF-ß and hsCRP in serum and synovial fluid (SF) were measured in all patients. Stepwse linear regression models were used to determine the correlation between SF- hsCRP as a measure of local inflammation with other systemic or local markers of inflammation.Results:A total of 40 patients (women 65%) with mean age 65.6+8.9 (49-86) years, mean BMI 27.7+3.7 (22-38) kg/m2, were analyzed. SF-hsCRP was positively correlated with serum hsCRP as well as serum and SF cytokines. Knee pain was positively associated with BMI and radiographic severity and negatively with quadriceps muscle strength (QMS) (r=-0.350, p=0.029). In stepwise linear regression analysis the SF-hsCRP was positively correlated with serum hs-CRP (r=0.769, p=0.001), SF-IL-17 (r=0.428, p=0.001) and negatvely with serum IL-10 (r=-0.316, p=0.002).Conclusion:These findings indicate that systemic markers of inflammation such as serum hsCRP, and IL-17 are associated with local inflamation in KOA.

Особливості клінічної діагностики та можливості магнітно-резонансної томографії при пігментному віллонодулярному синовіті (теносиновіальній гігантоклітинній пухлині) колінного суглоба

Особливості клінічної діагностики та можливості магнітно-резонансної томографії при пігментному віллонодулярному синовіті (теносиновіальній гігантоклітинній пухлині) колінного суглоба

Double-inversion recovery with synthetic magnetic resonance: a pilot study for assessing synovitis of the knee joint compared to contrast-enhanced magnetic resonance imaging.

To investigate the agreement between double-inversion recovery (DIR) with synthetic magnetic resonance imaging (MRI) and T1-weighted contrast-enhanced (CE)-MRI for the assessment of knee synovitis. T1-weighted CE-MRI and synthetic MRI of 30 patients were compared. Synthetic DIR image reconstruction was performed with two inversion times (280-330ms and 2800-2900ms). Subjective image quality, visibility of synovium, detection of synovitis, and total synovitis score in the knee joint were evaluated on both MR images. The relative signal intensity (SI) and relative contrast of synovium, joint effusion, and bone marrow for two imaging were assessed. Differences in data between two imaging were assessed by using Wilcoxon's signed-rank test and chi-square test/Fisher's exact test. Interobserver agreement was expressed as weighted kappa value. Accuracy of synthetic DIR image was calculated by using CE-MRI as reference standard. T1-weighted CE-MRI yielded better image quality than synthetic DIR imaging (p < 0.001). Interobserver agreements for detecting synovitis diagnosis/sum of the synovitis score were moderate to almost perfect (κ = 0.58/0.44, synthetic DIR; κ = 0.83/0.65, T1-weighted CE-MRI). There were no statistical differences in visibility of synovium (p = 0.058-0.190), detection of synovitis (p < 0.001), and relative SI of structures between two imaging (p = 0.086-0.360). Synovium-to-effusion contrast was higher in synthetic DIR (p = 0.003) and synovium-to-bone marrow contrast was higher in CE-MRI (p < 0.001). Synthetic DIR imaging showed a moderate degree of interobserver agreement and good accuracy for detecting synovitis. Though it has limitations, it may play a role in imaging of degenerative joint disease or larger cohort scientific studies where gadolinium application is not feasible. • Synthetic double-inversion recovery (DIR) imaging avoids the use of contrast agent. • There was no significant difference between T1-weighted CE-MRI and synthetic DIR imaging in evaluating presence of synovitis in knee joint. • Synthetic DIR imaging showed moderate degree of interobserver agreement and good accuracy for detecting synovitis compared to CE-MRI, and it may facilitate evaluation of some regions of peripatellar synovitis.

Downregulation of long noncoding RNA LOC101928134 inhibits the synovial hyperplasia and cartilage destruction of osteoarthritis rats through the activation of the Janus kinase/signal transducers and activators of transcription signaling pathway by upregulating IFNA1.

Osteoarthritis (OA) is the most common disease of arthritis, a chronic joint disease that is always correlated with massive destruction such as cartilage destruction, inflammation of the synovial membrane, and so on. This study aims to explore the role of long noncoding RNA (lncRNA) LOC101928134 in the synovial hyperplasia and cartilage destruction, more specifically, in the Janus kinase/signal transducers and activators of transcription (JAK/STAT) signaling pathway in an OA rat model. Microarray-based gene expression analysis was conducted to screen out the lncRNA differentially expressed in OA and predict the target gene of the lncRNA with the involvement of the signaling pathway through Kyoto encyclopedia of genes and genomes (KEGG) analysis. A model of OA was established and treated with the small interfering RNA LOC101928134/inhibitor of JAK/STAT signaling pathway to investigate the relationship among LOC101928134, IFNA1, and the JAK/STAT signaling pathway in OA. The effect of LOC101928134 on the serum levels of IFNA1, interleukin-1β, and tumor necrosis factor-α, and the apoptosis of synovial and cartilage cells was evaluated. LOC101928134, which was found to be highly expressed in knee joint synovial tissues of OA rats, regulated the expression of IFNA1 gene and inhibited JAK/STAT signaling pathway. Downregulation of LOC101928134 resulted in reduced knee joint synovitis, relived inflammatory damage, and knee joint cartilage damage of OA rats. Besides, synovial cell apoptosis was enhanced upon LOC101928134 downregulation, while cartilage cell apoptosis of OA rats was suppressed. These results demonstrate that downregulation of LOC101928134 suppresses the synovial hyperplasia and cartilage destruction of OA rats via activation of JAK/STAT signaling pathway by upregulating IFNA1, providing a new candidate for the treatment of OA.

Clinical effect and mechanism of heat sensitive moxibustion for knee joint synovitis

To observe the effect of heat sensitive moxibustion based on the articular injection for knee joint synovitis. Sixty-seven patients with knee joint synovitis were randomly assigned into an observation group (34 cases) and a control group (33 cases). Articular injection of triamcinolone was used in the control group for 2 courses, 2 times as a course, once 5 days. Based on the treatment in the control group, heat sensitive moxibustion was used in the observation group for 2 courses, 2 weeks as a course, 5 times a week. The acupoints were Yanglingquan (GB 34), Yinlingquan (SP 9), Liangqiu (ST 34), Xuehai (SP 10), Heding (EX-LE 2) or the pain point, subcutaneous nodules around the patella. American Knee Society (AKS) score was measured before and after treatment and one month after treatment. At the same time, the knee joint synovium thickness was measured by MRI; the knee joint effusion was observed by ultrasound; the serum interleukin-1 (IL-1) and matrix metalloproteinase-3 (MMP-3) were measured. After treatment, the AKS scores increased in the two groups (both P<0.05); after treatment and at follow-up, the AKS scores in the observation group were higher than those in the control group (both P<0.05); at follow-up, the AKS score in the control group was lower than that after treatment (P<0.05). After treatment, the synovium thickness, effusion, IL-1 and MMP-3 were lower than those before treatment in the two groups (all P<0.05); after treatment and at follow-up, the four indexes in the observation group were lower than those in the control group (all P<0.05); at follow-up, the four indexes in the control group increased than those after treatment (all P<0.05). Heat sensitive moxibustion combined with medicine articular injection can improve synovium inflammatory reaction and the absorption of effusion in the articular cavity,with long-time effect, which are better than simple medicine articular injection.