Hemarthrosis is the medical term for a bruise in the knee. This is when blood accumulates in the joint as a result of a knee injury.
What is hemarthros?
The term hemarthros is used to describe a bruise in the knee. The term should be distinguished from the term hematoma, in which there is an accumulation of blood in all parts of the body. A bruise is the leakage of blood flowing from an injured blood vessel. Subsequently, the blood is deposited in a body cavity or tissue. The bruise becomes visible by a bruise that forms on the knee in the case of hemarthrosis. The blood can no longer be removed by the veins. Therefore, the knee fills with blood, which leads to its thickening. As it progresses, the bruise takes on a yellowish color and then recedes.
Causes
Hemarthrosis can result from a variety of causes. In most cases, the bruise in the knee is caused by injuries to the joint structures. Sometimes, it is also a long-term consequence of wear and tear, chronic incorrect loading, or sports injuries. Some sports are considered particularly risky for the development of hemarthrosis. These include primarily soccer and skiing. The same applies to other sports in which the knee and leg are exposed to high stress. The knee is also at increased risk of rotational trauma. If the lower leg twists too much towards the thigh, there is a risk of injury to the menisci, the collateral ligaments or the cruciate ligaments. Injuries range from ligament stretching to ligament rupture. The jarring injuries often also affect the blood vessels that run through the knee. This, in turn, draws an effusion of blood into the adjacent tissues as well as the knee cavities. However, it is not uncommon for hemarthrosis to be caused by external impacts involving the kneecap (patella) or the bones. Heavy falls are usually responsible for this. In this case, hemarthros can be caused by a slight contusion as well as by a bone fracture. Sometimes surgical procedures on the knee are also responsible for the formation of a hemarthrosis. In this case, the surgery is classified by the body as an injury. Even the use of certain medications can be the reason for a hemarthros. If this is the case, the attending physician must prescribe a different medication. Not in every case a specific cause for a hemarthrosis in the knee can be found. Thus, the hemarthros then manifests without a previous injury.
Symptoms, complaints and signs
The symptoms of hemarthrosis depend on the extent of the bruise. If the bruise is minor, the affected person suffers only from pressure pain and mild swelling. A typical feature of hemarthrosis is a bluish discoloration of the knee. Initially, the injured area takes on a reddish discoloration that changes to blue and yellow as it progresses. If the hemarthros is extensive, it often becomes noticeable through permanent and more severe pain. Doctors also speak of a tension pain. It results from the spreading of the swelling caused by the hematoma. In addition, movement restrictions of the knee become apparent.
Diagnosis and course of the disease
If hemarthrosis of the knee occurs, medical evaluation is recommended. Thus, there is a risk of other injuries to the joint or bones and severe pain. The physician asks the patient to describe the cause of the injury. This is often sufficient to make the correct diagnosis. If the hemarthrosis is located at a deeper site, sonography (ultrasound examination) may be necessary. The course of a hemarthros depends on how quickly therapy is started. Thus, lesions can usually be kept to a minimum with early treatment. Without prompt therapy, there is a risk of permanent movement restrictions as well as damage to the cartilage.
Complications
The symptoms and complications of hemarthrosis depend greatly on the severity of the bruise and its cause, although in most cases it is an accident. As a rule, swelling occurs and the affected person suffers from pain.The pain usually occurs in the form of pressure pain, but can also occur as pain at rest, leading to sleep complaints. The affected area turns red or blue and may also pulsate. If the hemarthrosis is not treated, the pain usually does not disappear on its own and leads to a reduction in the patient’s quality of life. Furthermore, restrictions in movement also occur, which not infrequently can lead to psychological discomfort. The daily life of the affected person is made more difficult and the performance of ordinary activities is no longer possible without further ado. n most cases, no direct treatment of the hemarthrosis is necessary and it disappears again on its own. If it was a serious accident, it may be necessary to have it examined by a doctor. However, there are no particular complications or serious complaints. Life expectancy is also not affected by hemarthros.
When should you see a doctor?
Hemarthrosis is usually harmless and subsides on its own after a few days. Medical advice is needed if the bruise persists for more than a week. If severe pain or other symptoms occur, the hemarthros must be examined in any case. It is possible that the bruise is pinching off a nerve or pressing on the surrounding tissue. Larger effusions can also cause severe tension pain and restricted movement, requiring the use of painkillers and anti-inflammatories. Furthermore, a hemarthros should be taken to a doctor if there are concomitant other injuries or if there have been repeated episodes of bruising. If the hemarthros occurs after a surgical procedure on the knee, the responsible physician must be informed. Patients with chronic joint diseases or protracted sports injuries should also talk to the doctor and have the symptoms clarified. Other contacts are the orthopedist, a sports physician or a specialist in joint diseases. In case of severe complaints, a hospital visit is indicated.
Treatment and therapy
In most people, hemarthros goes away on its own, taking only a few days. The leaked blood clots and the organism breaks it down again with the help of enzymes. Due to the different degradation products, there are changing discolorations in red, blue and yellow. To counteract swelling of the knee, the patient should cool the joint immediately after the accident. In this way, the blood vessels contract and the bleeding decreases or even stops completely. Since the bruise in the knee cannot spread any further, the swelling also takes on smaller proportions. The doctor decides on the further therapy. If the cause of the hemarthrosis is eliminated, no further treatment is usually required. Thus, the bruise in the knee recedes completely after two to three weeks. To treat the pain, a special hematoma tape can be applied to the knee, which speeds up the healing process. Sometimes, however, the hemarthros may not heal on its own. In such cases, a joint puncture is performed. During this procedure, the doctor punctures the joint with a thin needle and draws out the blood. Usually, the patient feels an immediate improvement. Furthermore, an arthroscopy (knee arthroscopy) can be performed.
Prevention
To avoid hemarthrosis, caution should be taken during sports activities. For example, the knee should be protected from falls with special pads.
Aftercare
Aftercare aims to prevent the recurrence of symptoms. This is sufficiently known from cancer diseases. Scheduled follow-up examinations are intended to detect a tumor there at an early stage, thereby enabling the best possible treatment. Follow-up care for hemarthrosis, on the other hand, consists of preventive measures. This is intended to avoid the causes that trigger the disease. In concrete terms, this means avoiding overexertion during sports activities such as soccer and skiing. The attending physician will provide information about the dangers as part of the initial diagnosis. However, the implementation of the behavioral recommendations is the responsibility of the patient. In an unfavorable course, hemarthrosis can lead to permanent treatment. This is due to sustained damage. Typical complaints then include restricted mobility and pain.Medical support services then include physiotherapy. Scheduled follow-up examinations, which document the progress of the disease, are arranged individually. The frequency of these examinations depends on the symptoms. Sonography is a suitable method of detection. It is also possible to visualize hemarthrosis at deep sites. Furthermore, the patient’s presented symptoms allow a diagnosis. In any case, follow-up care is aimed at preventing the transition to arthrosis. This complication may cause further instability.
Here’s what you can do yourself
After an accident, the affected knee must first be cooled and immobilized. With the help of so-called hematoma tapes, which are glued to the affected skin, the swelling at the bruise can be further reduced. Insofar as the pain subsides quickly, the knee joint must be well observed for a few hours. If severe pain occurs or movement restrictions and further discomfort are added, medical treatment is required. Depending on which injury is diagnosed, various self-help measures can be taken afterwards. Strained and torn ligaments require medical therapy. There is not much the affected person can do himself here, except to take it easy on the knee and make use of the routine examinations in the doctor’s office. Bruises usually heal on their own after medical treatment. It is enough to cool the hemarthros and not to put any weight on the affected knee if possible. Curd packs and other home remedies may speed up the healing process. A surgery-related hemarthros must be presented to the responsible physician immediately. After surgery, the knee should be well monitored to prevent recurrence of hemarthrosis and associated further complications.
