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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 .
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.
Septic arthritis is the purulent invasion of a joint by an infectious agent [5] [6] with a resultant large effusion due to inflammation. [7] Septic arthritis is a serious condition. It can lead to irreversible joint damage in the event of delayed diagnosis or mismanagement. It is basically a disease of children and adolescence. [6]
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]
Arthrocentesis, or joint aspiration, is the clinical procedure performed to diagnose and, in some cases, treat musculoskeletal conditions. The procedure entails using a syringe to collect synovial fluid from or inject medication into the joint capsule .
Knee MRIs should be avoided for knee pain without symptoms or effusion, unless there are non-successful results from a functional rehabilitation program. [25] In some diagnosis, such as in knee osteoarthritis, magnetic resonance imaging does not prove to be clear for its determination. [26]
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A rheumatologist will aim to diagnose the cause of the patient’s pain by first determining whether it is inside the joint itself, meaning true synovitis, or if it is actually caused by an inflammation of the tendons, referred to as tendonitis. Imaging, such as an MRI or musculoskeletal ultrasound is often required to make a firm diagnosis.