A joint effusion is the presence of increased intra-articular fluid.
It may affect any joint. Commonly it involves the
knee
In humans and other primates, the knee joins the thigh with the leg and consists of two joints: one between the femur and tibia (tibiofemoral joint), and one between the femur and patella (patellofemoral joint). It is the largest joint in the hu ...
.
Diagnostic approach
The approach to diagnosis depends on the joint involved. While
aspiration of the joint is considered the gold standard of treatment, this can be difficult for joints such as the hip.
Ultrasound
Ultrasound is sound waves with frequency, frequencies higher than the upper audible limit of human hearing range, hearing. Ultrasound is not different from "normal" (audible) sound in its physical properties, except that humans cannot hea ...
may be used both to verify the existence of an effusion and to guide aspiration.
File:Knee effusion.jpg, Skyline view of the patella demonstrating a large joint effusion as marked by the arrow.
File:Sail sign.jpg, A schematic drawing showing the sail sign which represents an effusion.
Differential diagnosis
There are many causes of joint effusion. It may result from trauma, inflammation,
hematologic conditions, or infections.
[
]
Septic arthritis
Septic arthritis
Acute septic arthritis, infectious arthritis, suppurative arthritis, osteomyelitis, or joint infection is the invasion of a joint by an infectious agent resulting in joint inflammation. Generally speaking, symptoms typically include redness, hea ...
is the purulent
Pus is an exudate, typically white-yellow, yellow, or yellow-brown, formed at the site of inflammation during bacterial or fungal infection. An accumulation of pus in an enclosed tissue space is known as an abscess, whereas a visible collecti ...
invasion of a joint
A joint or articulation (or articular surface) is the connection made between bones, ossicles, or other hard structures in the body which link an animal's skeletal system into a functional whole.Saladin, Ken. Anatomy & Physiology. 7th ed. McGraw ...
by an infectious
An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable dise ...
agent with a resultant large effusion due to inflammation. Septic arthritis
Acute septic arthritis, infectious arthritis, suppurative arthritis, osteomyelitis, or joint infection is the invasion of a joint by an infectious agent resulting in joint inflammation. Generally speaking, symptoms typically include redness, hea ...
is a serious condition. It can lead to irreversible joint damage in the event of delayed diagnosis or mismanagement. It is basically a disease of children and adolescence.[
]
Gout
Gout
Gout ( ) is a form of inflammatory arthritis characterized by recurrent attacks of a red, tender, hot and swollen joint, caused by deposition of monosodium urate monohydrate crystals. Pain typically comes on rapidly, reaching maximal intensit ...
is usually present with recurrent attacks of acute inflammatory arthritis Inflammatory arthritis is a group of diseases which includes: rheumatoid arthritis, psoriatic arthropathy, inflammatory bowel disease, adult-onset Still's disease, scleroderma, juvenile idiopathic arthritis, and systemic lupus erythematosus (SLE).
...
(red, tender, hot, swollen joint). It is caused by elevated levels of uric acid
Uric acid is a heterocyclic compound of carbon, nitrogen, oxygen, and hydrogen with the formula C5H4N4O3. It forms ions and salts known as urates and acid urates, such as ammonium acid urate. Uric acid is a product of the metabolic breakdown of ...
in the blood that crystallizes and deposits in joints, tendons, and surrounding tissues. Gout affects 1% of individuals in Western populations at some point in their lives.
Trauma
Trauma from ligament
A ligament is the fibrous connective tissue that connects bones to other bones. It is also known as ''articular ligament'', ''articular larua'', ''fibrous ligament'', or ''true ligament''. Other ligaments in the body include the:
* Peritoneal li ...
ous, osseous or meniscal injuries can result in an effusion. These are often hemarthrosis
Hemarthrosis is a bleeding into joint spaces. It is a common feature of hemophilia.
Causes
It usually follows injury but occurs mainly in patients with a predisposition to hemorrhage such as those being treated with warfarin (or other anticoagulan ...
or bloody effusions.
Treatment
The treatment for Joint effusion include icing, rest and medication as advised by your doctor.
See also
* Swelling (medical)
Edema, also spelled oedema, and also known as fluid retention, dropsy, hydropsy and swelling, is the build-up of fluid in the body's tissue. Most commonly, the legs or arms are affected. Symptoms may include skin which feels tight, the area ma ...
* Intermittent hydrarthrosis
Intermittent hydrarthrosis (IH), also known as ''periodic synoviosis'', ''periodic benign synovitis'', or ''periodic hydrarthritis'', is a chronic condition of unknown cause characterized by recurring, temporary episodes of fluid accumulation (eff ...
References
External links
{{Medical resources
, DiseasesDB = 15237
, ICD10 = {{ICD10, M, 25, 4, M, 00
, ICD9 = {{ICD9, 719.0
Musculoskeletal disorders
Medical signs