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Knee effusion, informally known as water on the knee, occurs when excess synovial fluid accumulates in or around the knee joint. It has many common causes, including arthritis , injury to the ligaments or meniscus , or fluid collecting in the bursa , a condition known as prepatellar bursitis .
Repeated, periodic joint effusions of the knee. Usually one knee is affected but sometimes both knees. Other joints may also be involved along with the knee. Effusions are large, restricting range of motion but significant pain is not a feature. There is usually stiffness. Tenderness of the joint may or may not be present. [1]
The patellar tap is a technique used in an examination of the knee to test for knee effusion or "water-on-the-knee". [1] With the examinee lying on their back, the examiner extends the knee and presses the area above the kneecap with the palm of one hand. This pushes fluid under the kneecap and lifts it.
Gait assessment can be used to differentiate genuine knee pain or pain which referred from hip, lower back or the foot. A person can be asked to perform a duckwalk. This requires the person to squat and walk in that position. In order to perform a duckwalk, the person has to be free of ligamentous tear, knee effusions, and meniscal tears.
Patients with a fever, suspected flare of existing arthritis, or unknown cause of joint effusion should undergo arthrocentesis with synovial fluid analysis. Samples of synovial fluid can be analyzed for gross appearance, presence of crystals, white blood cell count with differential, red blood cell count, and bacterial culture.
While there are over 100 types of arthritis and related conditions, Dr. Gendai Echezona, a fellowship-trained, triple board-certified anesthesiologist specializing in interventional pain ...