Joint effusion

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Joint effusion
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 presense 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

File:Knee effusion.jpg
Skyline view of the patella demonstrating a large joint effusion as marked by the arrow.
File:Sail sign.jpg
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

References

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  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 9780323054720. 
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  6. Marx, John (2010). Rosen's emergency medicine: concepts and clinical practice 7th edition. Philadelphia, PA: Mosby/Elsevier. p. Chapter 53. ISBN 9780323054720.