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Plant thorn Synovitis

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Plant thorn Synovitis






What is Plant thorn Synovitis?


Plant thorn Synovitis is an arthritis that occurs in children who have fallen on a palm frond or similar piece of sharp plant material and a part of the plant has broken off inside the knee. The plants that tend to cause the most problems in this situation are palm trees, roses, black-thorn shrubs, cacti, bougainvillea, yucca, pyracantha, plum trees and mesquite trees. From a Doctors perspective, the usual story occurs when a four- to six-year-old child is brought to the doctor with a single swollen knee. The knee is usually red and hot with no history of injury. The family doctor sends the child to an orthopedist, who removes fluid from the knee. The fluid looks infected. The orthopedist sends the child to the hospital for intravenous antibiotic therapy. When the cultures of the knee fluid fail to reveal any bacteria and the knee fails to improve after four or five days of antibiotic therapy, it may be thought that this is Lyme disease that is not responding to the antibiotics. When the knee still does not get better after changing antibiotics, a diagnosis of juvenile arthritis is considered (Lehman, 2004).



Signs and Symptoms of Plant thorn Synovitis


The key to recognizing plant thorn synovitis is in taking a proper travel history. Usually the child has traveled to someplace warm (e.g., Florida, the Caribbean, Southern California) several weeks before the problem started. These are typically children who are just old enough to get out of sight and fall down. They have a small cut on the knee that heals quickly (Lehman, 2004).



Treatment options for Plant thorn Synovitis


In the first instance, plant thorn synovitis can be treated with anti-inflammatory medication to help relieve some of the inflammation associated with the skin puncture. Proper treatment does however require a synovectomy (cleaning out all of the inflamed tissue lining the knee). When this is done, the diagnosis of plant thorn synovitis can be confirmed by looking at the tissue under polarized light. This will show starch granules from the plant material that broke off inside the knee (Lehman, 2004).





Lehman, T.J (2004). It's not Just Growing Pains: A Guide to Childhood Muscle, Bone, and Joint Pain, Rheumatic Diseases, and the Latest Treatments Oxford University Press: New York.

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