KNEE SYNOVITIS WITH EFFUSION ("Water on the Knee") |
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General Information
DEFINITION--Inflammation of the synovium, the smooth, lubricated lining of the knee. The synovium's lubricating fluid helps the knee move freely and prevents bone surfaces from rubbing against each other. Inflammation triggers an excess of fluid production and accumulation in the knee. Synovitis with effusion is often a complication of a knee injury or of collagen diseases, such as gout or rheumatoid arthritis.
BODY PARTS INVOLVED
Synovium of the knee.
Bones of the knee joint, including the patella (kneecap), femur (thigh bone), and tibia and fibula (lower leg bones).
Ligaments and soft tissue of the knee joint, including the meniscus (cartilage of the knee).
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SIGNS & SYMPTOMS
Pain in the knee (sometimes).
Swelling above the kneecap.
Generalized swelling and redness if the inflammation is caused from infection or joint disease, such as gout, rather than from athletic injury.
CAUSES
Single injury or repeated injury that damages any part of the knee.
Bacterial infection (frequently gonorrhea).
Metabolic disturbance, such as an acute attack of gout or rheumatoid arthritis.
RISK INCREASES WITH
Participation in contact sports such as football, baseball, soccer or rugby.
Repeated knee injury.
Poor muscle strength or conditioning, which makes knee injury more likely.
Medical history of gout, rheumatoid arthritis, or other inflammatory joint diseases.
Infection in another joint.
Vitamin or mineral deficiency, which makes complications following injury more likely.
HOW TO PREVENT
Engage in a vigorous muscle strengthening and conditioning program prior to beginning regular sports participation. Warm up adequately before workouts or competition.
Wear protective knee pads during participation in contact sports.
WHAT TO EXPECT
APPROPRIATE HEALTH CARE
Doctor's care, including aspiration of fluid from the knee. Because most knee synovitis with effusion is caused by injury to some part of the knee, treating the underlying injury is as important as treating the effusion.
Self-care during rehabilitation.
Physical therapy.
DIAGNOSTIC MEASURES
Your own observation of symptoms.
Medical history and physical exam by a doctor.
X-rays of the knee joint.
Laboratory examination of fluid removed from the knee.
POSSIBLE COMPLICATIONS
Prolonged healing time if activity is resumed too soon.
Proneness to repeated knee injury.
Unstable or arthritic knee following repeated bouts of synovitis.
Chronic synovitis that may prevent athletic participation.
PROBABLE OUTCOMEKnee synovitis with effusion can usually be cured completely in 2 to 4 weeks with heat and corticosteroid injections. However, recurrences are common following minor knee injuries.
HOW TO TREAT
NOTE -- Follow your doctor's instructions. These instructions are supplemental.
FIRST AIDNone. This condition develops gradually.
CONTINUING CARE
Follow doctor's instructions for treatment of the underlying condition.
Use an elastic bandage to compress the knee after fluid has been removed and between physical-therapy sessions.
Apply heat frequently. Use heat lamps, hot soaks, hot showers, heating pads, or heat liniments and ointments.
Take whirlpool treatments, if available.
Massage gently and often to provide comfort and decrease swelling.
MEDICATION
Your doctor may prescribe:
Antibiotics if infection is present.
Non-steroidal anti-inflammatory drugs or antigout medicine.
Injection of a long-acting local anesthetic mixed with a corticosteroid to help reduce pain and inflammation.
You may take aspirin or ibuprofen for minor discomfort.
ACTIVITYContinue your usual activities during treatment if there is no pain, but protect the knee with tape and an elastic bandage during competitive sports. If you do have pain, reduce activities until pain subsides.
DIETDuring recovery, eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Increase fiber and fluid intake to prevent constipation that may result from decreased activity.
REHABILITATION
Begin daily rehabilitation exercises when pain subsides.
Use ice massage for 10 minutes before and after exercise. Fill a large Styrofoam cup with water and freeze. Tear a small amount of foam from the top so ice protrudes. Massage firmly over the injured area in a circle about the size of a softball.
See section on rehabilitation exercises.
CALL YOUR DOCTOR IF
Your knee becomes red, hot, swollen or painful.
After aspiration of fluid from the knee, you develop signs of infection (headache, fever, muscle aches, dizziness or a general ill feeling).
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