Articular effusion in the knee | Articular effusion

Articular effusion in the knee

A joint effusion in the knee is not uncommon. There are several possible causes that can cause joint effusion in the form of synovial fluid or blood in traumatic events, as well as pus in knee infections. A distinction should be made between acute and chronic joint effusion.

It is characterized by a swollen knee, which is accompanied by pain and limited movement. Typical causes of acute joint effusion in the knee are injuries of various kinds. In the forefront are injuries of joint structures caused by accidents.

Almost always an effusion is caused by injury to ligaments such as the cruciate ligament, but damage to the menisci also causes an accumulation of fluid in the knee. If the kneecap pops out, the knee swells just as frequently. In addition, an articular effusion in the knee can be a sign of overstrain due to sports without having damaged a structure.

Particularly in older people, the focus is on wear-related processes in the context of osteoarthritis, which are often accompanied by joint effusion in the knee. Another group of diseases that can cause an effusion in the knee are rheumatological diseases. Although the knee joint is usually not the main affected site of manifestation, it must be considered.

A chronic joint effusion in the knee is a typical sign of a bacterial infection. In this knee joint inflammation, the germs either enter the joint from outside through invasive procedures or injections or, in the case of general infections, reach the knee via the blood. The diagnosis of a knee joint effusion begins with a physical examination, in addition to the medical history.A swollen knee and pain give first indications.

The best known clinical sign is the “Dancing Patella”. Here, the knee is extended with both hands towards the patella, whereupon the patella offers elastic resistance by frontal pressure. The kneecap floats on the effusion.

Redness and overheating of the skin indicate infectious events. The effusion can be reliably recognized by means of: The simplest method is certainly the examination. A knee joint effusion above a certain size can be safely palpated by an experienced examiner.

• Ultrasound
• CT or
• MRI of the knee

The therapy depends on the cause of the symptoms. A simple joint effusion in the knee can be treated with immobilization, cooling and oral anti-inflammatory drugs such as Diclofenac. In the case of significant complaints such as purulent effusion, a knee puncture may be necessary to relieve the joint.

This must be performed under absolute sterility. At the same time, cortisone can be applied directly to the site of action during the puncture. Structural damage such as torn meniscus or torn ligaments usually requires surgical treatment.

Due to the everyday stress on the ankle, joint effusion is not uncommon at this site. The symptoms, including pain, swelling and loss of function, are typical symptoms of joint effusion. Articular effusion at the ankle also has various causes, the most common being traumatic events.

A typical symptom is a twisting of the ankle, which is called supination trauma (twisting outwards). It is the most common sports injury. The articular effusion in the ankle is caused by overstretching the lateral ligaments of the ankle and by the fact that the capsule apparatus of the joint is also severely strained.

A subsequent inflammatory reaction of the body leads to swelling and pain. This can also cause ligaments and blood vessels to tear, which worsens the joint effusion in the ankle and is usually accompanied by a pronounced bruise. Similarly, fractures of the ankle can cause joint effusion.

Besides the traumatic events, degenerative and infectious processes also cause joint effusion. Arthrosis, i.e. the wear-induced loss of joint cartilage and bone substance, is particularly important in old age. Arthritis, i.e. an inflammation of the ankle joint, is also not uncommon.

It can be caused by pathogens such as bacteria or it can be non-infectious in the context of rheumatological diseases or gout. In all cases there is an effusion of the joint at the ankle, which can be more or less pronounced. At the beginning, the doctor will clinically examine the ankle in addition to the medical history.

The swelling together with pain and possibly redness will quickly indicate the presence of a joint effusion. The mobility in the joint can be evaluated with some tests. In order to determine the cause and extent more precisely, examinations such as ultrasound and X-rays are then carried out.

This can confirm or exclude bony involvement. If an infectious joint effusion on the ankle is suspected, the effusion can be punctured to detect pus or blood. In rare cases, tests for rheumatoid diseases supplement the diagnosis.

Therapy for ankle effusion depends on the nature of the symptoms. Injuries are initially treated conservatively with rest, cold and also anti-inflammatory medication. Depending on the type of fracture, surgery may be necessary.

Antibiotics are indicated for pathogen-induced joint effusion. To relieve the effusion, a puncture of the ankle can also be considered.