Wrist synovitis - my problem and some questions

Benjy

For a couple of years I've been experiencing pain in my wrists, more so my right wrist - the pain mainly occurs when I rotate the wrist to the right and is especially bad if I am holding something as I rotate the wrist.

I saw my doctor about this, an MRI was done which showed a very small tear in the tissue but not enough to causer the pain. Eventually saw a hand surgeon who performed a wrist arthroscopy on my right wrist and found a lot of synovitis. I was watching the monitor as he carried out the procedure and he was basically hoovering up a lot of "cotton wool" like tissue, presumably the inflammation.

His notes described the issues as: ulnar gutter synovitis and significant dorsal synovitis.

This was last November. Sadly though this didn't fix the problem and I still get the same amount of pain (maybe a little more). Also my left wrist, which was previously only slightly affected, is now getting worse.

I saw the surgeon about 6 weeks after the op and reported to him, he said that as the op hadn't improved matters at that stage and given my condition the only other option might be to shave down one of the bones in the wrist (!!!) - I may be mis-rembering this though.

He said to give it a while and see him again in a few months - I am now due to see him again mid March.

However, I've kind of lost faith in him - he seems too "vague" for my liking.

Naturally I want to sort out this problem and I know that synovitis can cause other problems over time. But how do I find another surgeon? The guy that I saw (private treatment) was the only one in my area.

I live in south Wales.

No doubt I could ask my doctor but I guess he can only help with referrals in my local area.

I should say that I've also tried Naproxen to no avail.

I'm 53 years old.

There must be a way to fnd a really excellent surgeon who can deal with this.

Boomer13

Hi;

I've had a lot of wrist problems over 10 years, including a ligament tear in the left wrist and an old fracture of the styloid in the right. Neither wrist has good stability for twisting or load-carrying. I can't do much without pain. I have Psa inflammatory arthritis which was likely the cause of my issues.

I declined surgery on my wrist(s) and had prednisone injections instead. I've had two in the left wrist and one in the right. All have worked well to settle the pain and inflammation. I have had to modify all my life to accommodate the wrist problems, though. With arthritis problems in all my joints I no longer work but I my past jobs and hobbies were very physical. I found wrist supports helpful in the past and wear them mainly at night currently. They help with the pain.

Good luck, I hope you find a treatment that is helpful.

stickywicket

Hi Benjy and welcome to the forum. There are several things that spring to mind reading your post.

You are posting on an arthritis forum but don't mention arthritis only synovitis which can have several other causes in addition to arthritis. Have you actually had a diagnosis of arthritis? I hope you don't have arthritis as that isn't easily fixed. Maybe this has all arisen to to a sporting injury or repetitive strain.

You seem to think that surgery of some sort is the answer but I guess that depends on the question and whom you ask. Surgeons are always going to go for the surgical option as it's what they do. However, if your synovitis is caused by arthritis (and it sounds as if it might be if it's spreading to your other wrist) you might have to go down the medical route. I understand your wanting to 'sort this problem out' but it might just be something you have to learn to live with rather than 'sort out' permanently.

If you google 'hand surgeon Wales' several names come up and, if you are able to pay for private treatment, I guess it wouldn't matter that they were not in your PCT area. At least you'd get another opinion but it would be another surgical opinion. If the problem results from OA, or an autoimmune form of arthritis, it can't be a complete solution. (When you say you've tried naproxen, I wonder how long for. Sometimes meds have to be taken regularly, over some weeks, to make a difference.)

I wish you luck whatever you try next.

dreamdaisy

Oh my word, this takes me back! I lost a year of treatment in 2001 being gently bounced between rheumatology and orthopaedics, initially orthopaedics won and I had a massive amount of solid and liquid inflammation removed from my left knee in Feb. 2002: at the time of the op it was 27" in circumference. The tentative post-op diagnosis was 'pigmented villo-nodular synovitis' but apparently I lacked the required pigment. Eventually it was decided that I had some form of inflammatory arthritis and treatment began accordingly, then the swelling returned in my left knee in August 2002 and began in my right come mid- 2003. In 2006 I was finally diagnosed as having psoriatic arthritis (despite not having too much trouble with my skin) because my skin 'obliged' with a bout of pustular psoriasis.

I am not suggesting for one moment that this is what is affecting you but there are around 300 kinds of auto-immune inflammatory conditions and an accurate diagnosis can take time. I've learned that surgery is not necessarily the answer; I don't live in Wales so cannot help with your queries regarding surgeons but don't write yours off: he's not a rheumatologist which might be your next step to rule something out. I wish you well. DD