Abstract

Objective. In the article, the authors present a new extended classification of the clinical synovialogram, which they use in orthopedic practice. The term clinical synovialogram understands the possibility of characterizing articular or bursary puncture on the basis of clinical examination, based on a clinical analysis of the nature of evacuated exudates. Articular effusion for the conditions of the clinical synovialogram consider each pathological filling of the joint. They came to their results in the article based on theoretical analysis and their own experience in orthopedic practice.

Material and methods. The authors cite the classification of the clinical synovialogram, which has proven itself in practice, they have not encountered such a classification in the literature. It is a qualitative evaluation of effusion. In their orthopedic practice, they encounter exudate where arthritic classification is appropriate in orthopedic joint diseases, but also with effusions of traumatological etiopathogenesis and effusion in connection with orthopedic surgery- in orthopedic operations either arthroscopic reconstructive but especially in radical surgical procedures- in the implantation of total endoprosthesis. Based on such a broadly defined set of patients, they came to the need in practice for a new expanded clinical classification of articular effusion, which they define as a clinical synovialogram.  
Results. The usual classification of articular effusions is divided into non-inflammatory, inflammatory, infectious and hemorrhagic effusion. New knowledge of articular pathology and trauma allows for expanded possibilities of classification of articular effusions as follows: serous simplex exudate, mucinous viscous exudate, serous detrital exudate, serofibrinotic aseptic inflammatory rheumatic exudate, exudate inflammatory crystalline, exudate aseptic crystalline pyrophosphate and hydroxyapatite, exudate inflammatory infectious florid, exudate inflammatory infectious mitigated, hemorrhagic simplex exudate, hemorrhagic exudate  coagulated, exudate hemorrhagic livid, serohemoragic exudate, pneumohydrarthrosis and pneumohaemarthrosis, lipohaemarthrosis, metallotic exudate.  
Conclusions. The authors document the clinical classification of articular effusion – clinical synovialogram with sample imaging case studies mainly on the knee joint, which is most suitable for these analytical purposes. Based on their experience, they claim that the aforementioned clinical classification of effusion can be applied to each joint with correction of the anatomical size of the joint and the extent of the articular cavity with the synovial lining. Clinical synovialogram - extended qualitative analysis of articular effusion allows for more accurate diagnosis and differential diagnosis, targeted treatment, aftercare monitoring and orthopedic observation (Fig. 14, Ref. 16). Text in PDF www.lekarskyobzor.sk.
KEY WORDS: articular effusion, articular exudate, articular pathology, clinical synovialogram, classification of articular effusion.
Lek Obz 2022, 71 (10): 429-435

Jozef VOJTAŠŠÁK, Jr., Jozef VOJTAŠŠÁK, Elena PODSKOOVÁ, Veronika VOJTAŠŠÁKOVÁ

Orthos Paidion, špecializovaná ortopedická ambulancia,  Clinica orthopaedica, Bratislava, vedúci prof. MUDr. J. Vojtaššák, CSc.
Slovenská zdravotnícka univerzita, Fakulta ošetrovatestva Bratislava, dekan prof. PhDr. Z. Slezáková, PhD., MPH

CITE
VOJTAŠŠÁK J.jr., VOJTAŠŠÁK J., PODSKOOVÁ E., VOJTAŠŠÁKOVÁ V.: Clinical orthopedic synovialogram: a new extended classification. Lek Obz 2022, 71 (10): 429-435