Joint Or Bursal Aspiration
When a patient has a swollen knee, a doctor may want to verify or rule out certain diagnoses by analyzing the accumulated fluid. To do this, the doctor will remove fluid from the affected knee joint capsule or bursa using a needle and syringe. When performed on a joint capsule, this process is called joint aspiration or arthrocentesis. When performed on a bursa, this process is called bursal aspiration.
The doctor will take note of the aspirated fluid’s color and viscosity and may send it to a lab for further analysis. Determining the contents of the fluid can lead to an accurate diagnosis. For example, uric acid crystals in the joint fluid indicate gout, and bacteria in the fluid indicate infection.
See The Joint Aspiration Procedure
Aspiration and examination of the fluid are important diagnostic steps because the underlying cause of knee swelling will determine the appropriate medical treatment.
Aspirated fluids are not always sent to a lab for analysis. If a diagnosis is already known, a physician may perform an aspiration to improve joint function and patient comfort.
See Diagnosis through Synovial Fluid Analysis
How To Care For A Swollen Knee
When does a swollen knee require medical care, and when can it be treated at home? Mild to moderate knee swelling and knee effusionsometimes called water on the kneecan usually be treated at home. Medical attention is recommended if the knee is persistently swollen or accompanied by severe pain or other serious symptoms.
Read on to learn when to contact a doctor, how to treat a swollen knee at home, and how doctors can remove fluid from a knee using a process called aspiration.
How Serious Is A Baker’s Cyst
Baker’s cysts are fluid-filled sacs caused by excess knee-joint fluid.
This common condition occurs when excess fluid produced by the lining of the knee joint pushes through the back part of the joint capsule , forms a cyst and protrudes into the back area of the knee, known as the popliteal fossa. A Baker’s cyst may also be referred to as a “popliteal cyst.”
If you have osteoarthritis or rheumatoid arthritis, you may be familiar with this painful condition. Fortunately, there are treatment remedies available for Baker’s cysts, depending on the cause.
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When To See A Doctor And Medical Treatment Options
When to See a Doctor
If you have tried the above-mentioned measures at home and nothing seems to work than probably, its time to see a healthcare professional. If your knee is still swollen and doesnt look better at all, then seeing a doctor is necessary. Also, you must see a doctor in cases when you notice signs of an infection such as redness, hotness of the affected knee and even high temperature.
How to get rid of fluid on the knee? It is always a good idea to consult a healthcare professional immediately after a knee injury or in cases when your knee starts swelling without a reason. A workup in such cases includes:
- Complete medical history and physical examination of the affected knee. Your doctor will want to know about the symptoms you noticed or how the injury occurred, when the symptoms started or when the injury occurred, recent activities, past injuries, any surgeries or other medical condition.
- X-ray of the affected knee, especially in cases of an injury to reveal any broken bone or dislocated bone
- Ultrasound of the affected knee to reveal any abnormalities in the bones, ligaments, tendons, and surrounding tissue
- MRI providing a better visualization of the knee structures
- Joint aspiration collecting some knee fluid for further analysis with the help of a needle
Depending on the findings, proper treatment is recommended or you might be referred to an orthopedist for further evaluation.
Treatment
Commonly recommended treatments include:
How To Prevent Knee Effusions
You can keep healthy knee joints by doing 150-300 minutes of moderate-intensity aerobic activity and strength training twice a week.
Also, try to keep your BMI below 25. Some studies show that the higher the BMI, the more risk of having excess knee fluid.
If you have arthritis or any other medical condition, follow the indications of your doctors before starting any physical activity regime.
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First Of All You Need To Understand The Basic Anatomy Of Your Knee
Its a synovial joint which means it allows a lot of movement. This degree of movement is made possible largely because of fluid within and around the bones and other soft tissue that make up your knee.
The synovial fluid in the knee basically reduces friction between the joints moving parts, similar to how gear oil helps your car to run smoother. Its also what most people consider water on the knee.
So, if youve ever wondered, is it bad if you have fluid in your knee?
No, its not. Having fluid in the knee joint is actually normal. But, also like gear oil, the problem begins when you have too little or too much.
Knee Aspiration: Everything You Need To Know
The knee can get affected in injuries, joint conditions or systemic illnesses, leading to pain and swelling of the knee joint. Knee swelling is mainly accumulation of fluid in or around the joint. Knee effusion or water on knee commonly occurs due to acute trauma, arthritis and other forms of joint disorders or infection.
In such situations, knee joint aspiration, also known as arthrocentesis is performed for aspiration of excess fluid. It can be performed as a diagnostic as well as treatment modality.1
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How Does Arthrocentesis Work
Fluid buildup in joints puts pressure on the joint. Excess fluid causes pain and swelling. You may find it difficult to bend and move the joint.
Your healthcare provider may drain the fluid and send a sample to a lab. Tests can determine the cause of the fluid buildup.
As a treatment, joint aspiration eases swelling and joint pressure. You should have less pain and find it easier to move after this procedure. Excess fluid often comes back. You may need joint aspiration again.
Healthcare providers typically use arthrocentesis on the:
- Hips, knees, ankles and feet.
- Elbows, shoulders, wrists and hands.
Fluid In Knee Symptoms
Symptoms of fluid on knee include:
- Swelling all around the knee.
- Difficult knee joint movements.
- Pain while walking, climbing stairs and various other different activities.
- Stiffness of knee joint.
- In case of septic arthritis, it may turn warm, red and extremely painful.
It is best for you to get a medical checkup in case of fluid on knee your doctor may suggest fluid removal if the fluid is in excess and you are having pain and difficulty in movement.
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Natural And Medical Ways To Remove Knee Fluid
A trauma to the knee, a ligament tear, arthritis, infections or even an overuse of the knee often leads to an accumulation of fluid around the knee joint. If this occurs, the affected knee will be swollen and appear larger than the other knee, painful to touch and in movement, stiff, bruised, etc. How to get rid of fluid on the knee? Depending on the underlying cause, you can get rid of excess fluid on the knee with at home treatments or medical treatments prescribed to you by a healthcare professional.
How Do You Remove Fluid From Knee Joints Naturally
Natural home remedies for removing fluid from knee joints include the RICE protocol for reducing swelling. Other treatments include herbal supplements and alternative forms of physical therapy, as stated by Healthline.
Fluid builds in the knee as a result of several different factors. Injuries such as fractures, ligament or meniscus tears, and overuse trauma all draw fluid to the knee. Such conditions and diseases as osteoarthritis, rheumatoid arthritis, gout, infection, bursitis, bleeding disorders, tumors and cysts all lead to fluid gathering around and inside the knee joint, according to Mayo Clinic.
When carrying out the RICE protocol, sitting on a couch, elevating the feet on a cushion, and applying a bag of ice or frozen small vegetables to the knee reduces swelling. Using a compression bandage while going about normal daily activities applies pressure to fluid, sending it out of the joint. Some natural supplements that help reduce knee swelling include ginger extract, willow bark, glucosamine and chondroitin sulfate. Ginger extract and willow bark reduce pain and inflammation, and chondroitin sulfate and glucosamine address more severe cases of pain and swelling. Tai chi is an alternative form of physical therapy that boosts flexibility and balance. It also increases range of motion, fighting the tendency to remain sedentary that accompanies pain and allows fluid to build as well, notes Healthline.
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Otc Pain Relievers Nsaids And Topical Salicylates
Over-the-counter medications are also options. You can buy them virtually anywhere without needing a doctors prescription and come in various brands and types.
Per MedlinePlus, there are 2 main types of oral OTC pain relievers you can buy:
- Acetaminophen , and
- NSAIDs
Acetaminophen has no anti-inflammatory properties but it does help you manage the pain. Popular examples include Tylenol and Panadol.
NSAIDs, on the other hand, have anti-inflammatory properties as well as pain-relieving properties. Examples include Advil, Aleve, Celebrex, and several others.
Apart from oral medication, you could also get topical salicylates.
Topical salicylates are technically still considered NSAIDs, so they can also help reduce pain and swelling.
For those of you whose stomachs dont react well to oral NSAIDs, these topical alternatives may be the better option.
However, Harvard says that topical NSAIDs arent as effective as their oral counterparts because your body absorbs less of the medicine. So, you might not feel the same exact relief. Also, dont apply these on wounds or rashes.
What Are Joint Injections
After joint aspiration, your healthcare provider may inject corticosteroids into the joint. This anti-inflammatory medication eases pain, swelling and stiffness. The drugs may also slow the return of excess fluid to the joint.
Steroid injections work best for inflammatory conditions like arthritis and tendonitis. Treatment effects last a couple of months. You shouldnt get more than four injections in the same joint within a year. Steroid overuse can damage the joint and weaken supporting tendons and ligaments.
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Who Performs A Joint Aspiration
Joint aspirations can be performed under medical guidelines by qualified doctors, including general physicians, internists, orthopedic surgeons, rheumatologists, interventional radiologists, emergency room physicians, as well as nurse practitioners and physician assistants.
Medical complications of joint aspiration are uncommon. Possible complications of the aspiration procedure include a reaction to the local anesthetic, local bruising or, minor bleeding into the joint. If cortisone is used, there may be loss of pigment in the skin . A rare but serious complication of the procedure is infection of the joint .
With corticosteroid injections, additional uncommon complications include inflammation in the joint as a result of the medication crystallizing, shrinkage or loss of pigment of skin at the injection site, increased blood sugar , and aggravation of preexisting infection elsewhere in the body. If multiple injections with corticosteroids are given too frequently, it is possible to develop systemic side effects , such as weight gain, puffy face and trunk, and easy bruising. Injection of hyaluronic acid derivatives may cause local inflammation and swelling of the joint due to a reaction to the medication. Hyaluronic acid injections into the knee joint for pain relief are generally given no more frequently than every six months.
Your Joint Contains Fluid
Before having a joint aspiration, its helpful to know a bit about the area it will target. A joint capsule is made up of flexible soft tissues that envelope a jointthe area where the two bones meet.
- Normally, a joint capsule contains just a drop or two of joint fluid .
- A joint that is inflamed by arthritis may contain several times the normal amount of fluid.
- The joint capsule may also contain blood after an acute injury or pus during an infection .
Depending on the joint and your anatomy, a joint may contain excess fluid but not appear swollen.
Joint aspiration may be recommended because:
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Natural Home Remedies For Water On Knee
However at your end when the cause is not serious, you can try several home remedy for fluid on knee.
- Give sufficient rest to the knee and avoid all the strenuous activities. Rest in bed for a week to achieve good recovery.
- Ice fomentation for 10 minutes at a regular interval is beneficial in reducing fluid on knee.
- Elevate your leg, so that the accumulated fluid will disperse naturally from the knee cavity. When you lie down, keep one to two pillows underneath your legs to keep your knee elevated.
- Fortnight after the injury, you should gradually start exercising to make your knee and leg muscle strong. You have to abstain from strenuous exercise, instead consult a physiotherapist he will guide you to do several physiotherapy knee strengthening exercises. Quadriceps and hamstring stretch is the most effective knee exercise.
- Knee support stockings are also beneficial when you have fluid on knee due to osteoarthritis.
- In case you are suffering from gout, try to avoid foods which increases uric acid in the blood such as legumes, eggs, red meat, beer and alcohol processed foods etc.
- Reduce your weight if you are overweight, obesity affects your knee joint in a long run.
- Include celery and parsley in your food they are known to drain the body of excess fluids.
- Wrap a compression bandage around the knee. It will support the knee, reduce the swelling and improve circulation.
Treating A Baker’s Cyst
Treatment will not usually be necessary if you have a Baker’s cyst that is not causing any symptoms.
Painkillers such as paracetamol and ibuprofen can be used to reduce the swelling and relieve any pain. A knee support or an ice pack may also help. A bag of frozen peas wrapped in a tea towel works well as an ice pack.
If you have an underlying condition that’s causing your cyst, it’s important that the condition is properly managed. The cyst may disappear when the condition causing it has been treated.
In some cases, it may be possible to drain the cyst. Surgery may also be needed to repair any significant damage around the knee joint.
Page last reviewed: 04 October 2021 Next review due: 04 October 2024
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Lateral Collateral Ligament Injury
The lateral collateral ligament is one of the four main ligaments of the knee. It connects the outer side of the femur and tibia and is primarily responsible for stabilizing the outer aspect of the knee.
An LCL injury is often the result of a blow to the inside part of the knee this causes the LCL to stretch beyond normal and can result in partial or complete tearing of the ligament.
Symptoms may include soreness on the outside of the knee, swelling, and stiffness. You may experience instability a feeling that the knee is unstable and going to buckle or give out.
32 million adults in the United States.
With aging, the cartilage that helps cushion the ends of bones in the knee joint can wear thin and eventually allow the bones to rub together. Pain, stiffness, and loss of joint movement can follow.
Some people have more significant wearing of the cartilage in the outer compartment of the knee joint and this can lead to lateral sided knee pain.
When To Contact A Doctor
Below are guidelines to help people decide if their knee swelling requires medical attention. If the person is still unsure whether to seek professional medical treatment, a phone call to a doctor or nurse can help determine whether an office visit is necessary.
A doctor should be contacted if:
- The knee is severely swollen or has a pronounced abnormality
- The knee cannot fully straighten or fully bend
- The knee is severely painful
- The person cannot bear weight on the knee, or feels as if the knee is going to “give out”
- The skin over the knee turns hot or red
- The person has a fever of 100.4° F or higher
- Knee swelling has been present for 3 days or longer
A doctor will examine the patient’s knee and ask the patient several questions. The physical examination and patient interview may provide enough information to make an accurate diagnosis. If more information is needed, the doctor may recommend medical imaging, such as an x-ray, or removing fluid from the knee using an in-office procedure called aspiration.
Leg swelling may be a cause for concernContact a doctor if the swelling affects the leg, not just the knee. Leg swelling can be a sign of a serious health problem.1,2
Seek immediate care if the leg swelling occurs suddenly with no known reason, particularly if it is accompanied by symptoms such as leg pain, chest pain, and/or problems breathing, as these may be signs of a life-threatening blood clot.
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What Is The Recovery Period Following Knee Aspiration
In most cases, removal of excess fluid provides great relief in reducing swelling, pain and also improves joint movement. Further medications and joint compression helps to prevent recurrence. While improvement continues complete relief may be obtained in few weeks to months depending on the underlying cause of knee swelling. In some cases appropriate repair procedures may have to be performed.
It is important to follow medical advice regarding rest, movement of legs and other activities. It is advisable to avoid strenuous activities for a few days after the procedure. Medical opinion should be sought if there is redness, soreness, excessive pain, bleeding or oozing from the aspiration site, fever within few days of the procedure.