Doctor’s Orders

What’s Synovitis—and How Sick Will It Make Lady Gaga?

Dr. Kent Sepkowitz on what’s strange about the diagnosis.

Lady Gaga fans weren’t happy to learn a new word this week: “synovitis.” That’s the reason the Mother Monster gave for cancelling the remaining dates on the American leg of her global stadium tour. Gaga said she had a tear in her right hip and would need surgery. The announcement sent her legions of followers scurrying to various sources to determine just what on earth synovitis is and why Lady Gaga (née Stefani Joanne Angelina Germanotta) of all people should have it.

Synovitis has many causes, but for such a young, healthy, hyper person like Lady Gaga, it’s likely due to being so hyper. For anyone who has seen a Gaga show or even a clip, it is clear that she works hard for the money. She dances and moves and leaps small buildings. She is all over the damn place. The group of aches and pains of which synovitis is a charter member is often referred to as in the "overuse” group of syndromes—those very things that happen because our bodies are built to jump around wildly maybe 50 times a year, so that when a person tries to jump around wildly 500 times a year, somethin's gotta give.

But really now—what is synovitis? Have a look here to understand the anatomy of a human joint. It’s pretty busy in there: designed for animals to be able to rotate, extend, and flex, the joint contains several different types of tissue. The joint itself is sort of like a bag that is compressed together by two opposing bones. In the knee, for example, the thigh bone sits just above the shin bone, each of them punching into the joint that sits between them. The inner lining of that bag is the synovial surface, a metabolically active cell layer that produces fluid to keep the knee moving smoothly. And when inflamed, it makes more fluid, enough that the knee might swell and hurt like crazy. Once in a while, the fluid—so-called “water on the knee” —is drained off for comfort.

Though painful and often really painful—more or less like someone took a heated knife and stabbed you in the joint—this sort of thing is not really dangerous. Miserable? You bet. But not worse. Oh sure, there are scary diseases that synovitis can be a symptom of, including lupus, which Lady Gaga disclosed in 2010 she may suffer from. Lupus is a protean disease that can cause inflammation in just about every part of the body, including the synovium. Tests for the disease, though, are problematic; no single result cinches the diagnosis. Furthermore, Lady Gaga referred to her condition as “borderline,” suggesting some symptoms—perhaps synovitis—and a blood test that fell in that large gray zone of maybe-positive results. Time will tell if she indeed is beginning to become ill from lupus, but without knowing more than what she revealed during her discussion with Larry King a few years ago, it is more likely she is having trouble walking and dancing because she walks and dances too damn much.

Most interesting is that her people and she are referring to the problem as “synovitis” at all, when “arthritis” would be just as apt a word. One, however, can only imagine the gasps and panic from her PR staff at the notion that their 26-year-old meal ticket might be associated with such a senile, granny-ish, emphatically un-hip term. Arthritis … what’s next, Geritol? Late-night ads for cardiac alert alarms? It’s a slippery slope toward obsolescence when your brand is expressly about youthful iconoclasm, deliberate posturing to épater la bourgeoisie.

But the wordsmiths and alchemists who have successfully elevated the gangly singer from anonymity to pop superstardom understand all too well the delicacy of a word. And “synovitis” has a fiercely medical sound, harsh and precise, and provides a very specific anatomic explanation. Alternatively and more seriously, it may be that Lady Gaga is beginning to prepare her fans for additional disclosures about lupus. Here too, we can only speculate.

I imagine that Lady Gaga will suffer this for a while and, like a jock with knee tendonitis, will have good days and bad. She may have some injections into the joints to simmer down the inflammation and pain (not recommended, Gaga, if you’re listening).

But it is very unlikely she will do the one thing that will make her joints feel better: rest. For her to resume being full-speed-ahead Lady Gaga, she’s first going to have to spend a long while being the woman behind the star, Stefani Germanotta, a skinny, achy, sweet-enough girl from the Upper West Side.