Synovitis secondary to non-metallic foreign bodies.

Eight cases of non-metallic foreign body synovitis are presented. In all cases, an apparently innocuous penetrating injury led to synovitis, and early articular cartilage destruction. Delay in appropriate diagnosis frequently occurred because of confusion regarding the management of these injuries. Pitfalls identified were: 1) failure to appreciate the seriousness of the initial injury and to debride the wound appropriately; 2) failure to obtain satisfactory initial radiographs; 3) failure to explore the wounds surgically; 4) failure to appreciate that a symptom-free interval may follow foreign body penetration. Synovectomy was necessary in six cases to ensure removal of either microscopic or hidden gross particulate matter. Pathologically, these specimens showed chronic synovitis and foreign body granuloma. The implications of such foreign bodies to longterm joint degeneration are discussed.