Joint effusion
| Joint effusion | |
|---|---|
| Specialty | Rheumatology  |
A joint effusion is the presence of increased intra-articular fluid.[1] It may affect any joint. Commonly it involves the knee.
Differential diagnosis
There are many causes of joint effusion. It may result from trauma, inflammation, hematologic conditions, or infections.[1]
Septic arthritis
Septic arthritis is the purulent invasion of a joint by an infectious agent[2] with a resultant large effusion due to inflammation.[3]
Gout
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
Trauma from ligamentous, osseous or meniscal injuries can result in an effusion.[5] These are often hemarthrosis or bloody effusions.
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 may be used both to verify the existence of an effusion and to guide aspiration.[6]
See also
References
- ^ 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.
- ^ "septic arthritis" at Dorland's Medical Dictionary
- ^ Marx, John (2010). Rosen's emergency medicine: concepts and clinical practice (7th ed.). Philadelphia, PA: Mosby/Elsevier. p. Chapter 134. ISBN 978-0-323-05472-0.
- ^ 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.
- ^ Johnson MW (April 2000). "Acute knee effusions: a systematic approach to diagnosis". Am Fam Physician. 61 (8): 2391–400. PMID 10794580.
- ^ Marx, John (2010). Rosen's emergency medicine: concepts and clinical practice (7th ed.). Philadelphia, PA: Mosby/Elsevier. p. Chapter 53. ISBN 978-0-323-05472-0.