Joint effusion

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Joint effusion
Kneeffusion.JPG
A traumatic right knee effusion. Note the swelling lateral to the kneecap as marked by the arrow.
ICD-10 M25.4
ICD-9 719.0
DiseasesDB 15237

A joint effusion is the presence of increased intra-articular fluid.[1] It may affect any joint. Commonly it involves the knee.

Differential diagnosis[edit]

There are many causes of joint effusion. It may result from trauma, inflammation, hematologic conditions, or infections.[1]

Septic arthritis[edit]

Septic arthritis is the purulent invasion of a joint by an infectious agent[2] with a resultant large effusion due to inflammation.[3]

Gout[edit]

Gout is usually present with recurrent attacks of acute inflammatory arthritis (red, tender, hot, swollen joint). It is caused by elevated levels of uric acid 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.[4]

Trauma[edit]

Trauma from ligamentous, osseous or meniscal injuries can result in an effusion.[5] These are often hemarthrosis or bloody effusions.

Diagnostic approach[edit]

Skyline view of the patella demonstrating a large joint effusion as marked by the arrow.
A schematic drawing showing the sail sign which represents an effusion.

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 may be used both the verify the existence of an effusion and to guide aspiration.[6]

See also[edit]

References[edit]

  1. ^ a b Mathison DJ, Teach SJ (November 2009). "Approach to knee effusions". Pediatr Emerg Care 25 (11): 773–86; quiz 787–8. doi:10.1097/PEC.0b013e3181bec987. PMID 19915432. 
  2. ^ "septic arthritis" at Dorland's Medical Dictionary
  3. ^ Marx, John (2010). Rosen's emergency medicine: concepts and clinical practice 7th edition. Philadelphia, PA: Mosby/Elsevier. p. Chapter 134. ISBN 978-0-323-05472-0. 
  4. ^ Chen LX, Schumacher HR (October 2008). "Gout: an evidence-based review". J Clin Rheumatol 14 (5 Suppl): S55–62. doi:10.1097/RHU.0b013e3181896921. PMID 18830092. 
  5. ^ Johnson MW (April 2000). "Acute knee effusions: a systematic approach to diagnosis". Am Fam Physician 61 (8): 2391–400. PMID 10794580. 
  6. ^ Marx, John (2010). Rosen's emergency medicine: concepts and clinical practice 7th edition. Philadelphia, PA: Mosby/Elsevier. p. Chapter 53. ISBN 978-0-323-05472-0.