KNEE SYNOVITIS WITH EFFUSION("Water on the Knee")
KNEE SYNOVITIS WITH EFFUSION
("Water on the Knee")
DESCRIPTIONKnee synovitis with effusion is 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.
Appropriate health care includes:
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.
SIGNS & SYMPTOMSPain in the child's knee (sometimes).
Swelling and heat 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.
CAUSESSingle 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.
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.
PREVENTING COMPLICATIONS OR RECURRENCE
Your child should engage in a vigorous muscle strengthening and conditioning program prior to beginning regular sports participation. The child should warm up adequately before workouts or competition.
Your child should wear protective knee pads during participation in contact sports.
MEDICAL TESTSYour 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 COMPLICATIONSProlonged 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.
Knee 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.
Use an elastic bandage to compress the child's 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.
The child can take whirlpool treatments, if available.
Massage gently and often to provide comfort and decrease swelling.
MEDICATIONYour doctor may prescribe antibiotics if infection is present; non-steroidal anti-inflammatory drugs or anti-gout medicine; injection of a long-acting local anesthetic mixed with a corticosteroid to help reduce pain and inflammation.
Give the child aspirin or ibuprofen for minor discomfort.
ACTIVITYYour child can continue the usual activities during treatment if there is no pain, but protect the knee with tape and an elastic bandage during competitive sports. If there is pain, your child should reduce activities until the pain subsides.
Use ice massage on the child 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.
DIET & FLUIDS
OK TO GO TO SCHOOL?Yes, when condition and sense of well-being will allow.
CALL YOUR DOCTOR IF
Your child's knee becomes red, hot, swollen, or painful.
After aspiration of fluid from the knee, your child develops signs of infection (headache, fever, muscle aches, dizziness, or a general ill feeling).