Is it synovitis or osteoarthritis in my knee, and can it be both?

The short verdict

Synovitis is a description of what the lining is doing, not a diagnosis by itself. In many older adults with knee arthritis, flares of swelling are synovitis on top of osteoarthritis. In a younger person, or when several joints are involved, synovitis may point to inflammatory arthritis, crystals or another cause that needs specific treatment. Finding the reason behind the synovitis is what guides treatment.

How they compare

• What is affected: synovitis involves the joint lining; osteoarthritis involves the cartilage and underlying bone
• Main symptoms: synovitis causes swelling, warmth and stiffness, often fluctuating; osteoarthritis causes pain with activity, stiffness after rest and sometimes grinding
• Course: synovitis may come and go in flares; osteoarthritis tends to change slowly over years
• Imaging: ultrasound or MRI shows synovitis; X-ray shows osteoarthritis as joint space narrowing and bone spurs
• Blood and fluid tests: help find inflammatory arthritis, gout or infection behind synovitis
• Treatment: synovitis may respond to anti-inflammatory medicine, an injection, or treating the underlying disease; osteoarthritis is managed with exercise, weight management, injections and, in advanced cases, surgery

Who each tends to affect

Osteoarthritis-related synovitis tends to affect adults over 50, people with previous knee injuries, those carrying extra weight and manual workers who kneel or squat. Synovitis from other causes tends to affect people with rheumatoid or psoriatic arthritis, gout, recent infections, bleeding disorders, or, rarely, a condition of the lining itself that causes repeated swelling in one knee of a younger adult.

When to see a knee surgeon in Doha

Go to emergency if the knee is hot, red and very painful, especially with fever. Book an assessment if swelling keeps returning, lasts more than a few weeks, or affects a younger person without an injury. Dr. Gelber at Aman Hospital will examine the knee, drain and test fluid if needed, review imaging and work with a rheumatologist when an inflammatory cause is suspected.