Is There Anything Else I Need To Know About A Synovial Fluid Analysis
Arthrocentesis, the procedure used to do a synovial fluid analysis, may also be done to remove excess fluid from a joint. Normally, there is only a small amount of synovial fluid between the joints. If you have a joint problem, extra fluid can build up, causing pain, stiffness, and inflammation. This procedure can help relieve pain and other symptoms.
If You Have A Lot Of Swelling Hyaluronic Acid Is Really Not Going To Help
You have a lot of swelling and pressure in your knee because you have too much water on the knee or in reality too much synovial fluid. That is a simple explanation. Many people find relief when this fluid is drained. So will people find relief if more fluid is added? It seems counterproductive for knee pain relief. This is why there is a debate over the long-term effectiveness of hyaluronic acid injections for knee osteoarthritis. We are only going to present one study here, please see our article: Research and reviews of Hyaluronic injections for Knee Osteoarthritis for more on this topic.
Getting back to the question above does injecting hyaluronic acid, putting more synovial type fluid in your knee, work when you already have an overabundance of this fluid? For some, the answer is yes it helps. For others, it does not help.
A January 2021 study in the medical journal Rheumatology explains it. What the researchers in this study set out to do was to determine whether ultrasound-detected synovitis affects the therapeutic efficacy of hyaluronic acid injection for treating knee osteoarthritis.
- The 137 patients in this study received hyaluronic acid injection two times at 2-week intervals.
- Initially, all the patients were helped. However, the patients who had ultrasound detected suprapatellar effusion had greatly reduced benefits from the injections.
How To Get Rid Of Fluid On The Knee Treatments Symptoms
Otherwise known as knee effusion, water or fluid on your knees is a clear sign that something isnt right. Moreover, there are several things that can cause this, such as arthritis and injuries, and how to get rid of fluid on the knee may depend on the underlying cause.
So, today, allow me to show you a few treatments and options, along with why you might want to go a certain route.
But, just so Im sure were on the same page, lets get our definitions straight.
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Chronic Knee Swelling Is Developing And Worsening Knee Osteoarthritis
In this video Danielle R. Steilen-Matias, MMS, PA-C offers a brief summary of the constant degenerative process going on in your knee that shows itself every day to you as swelling.
Summary and learning points:
- Many patients tell us that their other health care providers and doctors dismiss or ignore their complaints of knee swelling. However, as research suggests, such as the research examined in this article, is that chronic knee swelling signifies the early development of osteoarthritis.
- The reason the knee is swelling relates to the strength or integrity or lack thereof of the soft tissue around the knee. So the knee swelling can be coming from knee ligament injury or instability. Your body, in an attempt to provide stability for the unstable knee, will swell the knee as a protective mechanism to provide stability to the need temporarily. It should be temporary. Your body is swelling the knee until healing of an injury can take place. The fluid fills the knee to also prevent excessive movement to accelerate healing. When the injury is healed the swelling goes away.
- If you do a job that is very physically demanding, you are on your feet all day, you climb ladders or steps, etc, that is a lot of strain to be putting on your knees and your body does the best it can to provide the swelling necessary to keep your knee together. The problem is chronic swelling is causing a rapid degeneration in the knee.
Will My Knee Feel Better If The Doctor Removes The Fluid In It

OA of the knees sometimes causes fluid to fill the joint, which causes swelling and pain. While this condition is commonly called water on the knee, doctors may refer to the increased fluid more formally as a joint effusion. All of the movable joints in the body are surrounded by a layer of cells called the synovial membrane.
This layer of cells normally produces a small amount of fluid, whose purpose is to lubricate the joints. OA can lead to irritation of the synovium and cause it to produce larger than normal amounts of joint fluid. This extra fluid may create visible swelling of the knee as well as increased pain and stiffness. If you develop swelling and pain in your knee, your doctor may suggest that you have the fluid removed in a procedure called an arthrocentesis.
Arthrocentesis
The removal of fluid from a joint also called joint aspiration. In this procedure, a sterile needle and syringe are used to drain fluid from a joint that is inflamed or infected.
Your physician may remove this fluid for two reasons. First, the procedure is diagnostic and can help your doctor determine what is causing the swelling. Second, the procedure itself may be therapeutic and help relieve the pain and stiffness of the knee.
Examination of the physical properties of the joint fluid, such as its color and clarity, and its white blood cell count can assist the physician in making these important determinations.
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Synovial Fluid Accumulated In The Bursae Around The Knee Joint
Doctors in Taiwan publishing their study in the medical journal Experimental Gerontology examined the effects of Platelet Rich Plasma on synovial fluid volumes, protein concentrations, and severity of pain in patients with knee osteoarthritis. Here is their research summary:
- Patients with knee osteoarthritis are often complicated with joint soreness, swelling, weakness, and pain. These complaints are often caused by the excessive amount of synovial fluid accumulated in the bursae around the knee joint.
- They examined the effectiveness of platelet-rich plasma in treating patients with minor to moderate knee osteoarthritis combined with supra-patellar bursitis.
- Twenty-four elderly patients with minor to moderate knee osteoarthritis combined with supra-patellar bursitis were recruited.
- Aspiration of the synovial fluid was performed under ultrasound followed by subsequent PRP injections.
- Three monthly PRP injections were performed to the affected knees for a total of 3 months.
- Approximately after the 2nd PRP injection, significant decreases in synovial fluid total protein concentrations and volumes , and Lequesne index values were observed.
- Therefore, at least two monthly PRP injections may be beneficial for treating patients with minor to moderate knee osteoarthritis combined with supra-patellar bursitis.
A Villain In All This The Synovial Macrophages Eating Away At Your Knee
First, lets identify what Synovial macrophages are. A paper in the journal Frontiers in Immunology describes them this way: Synovial macrophages are one of the resident cell types in synovial tissue and while they remain relatively quiescent in the healthy joint, they become activated in the inflamed joint and, along with infiltrating monocytes/macrophages, regulate the secretion of pro-inflammatory cytokines and enzymes involved in driving the inflammatory response and joint destruction. Probably what you got the most out of this paragraph is driving the inflammatory response and joint destruction.
How are the synovial macrophages doing it? By bloating chondrocytes and making them puke up corrosive substances in your knee
Here is a May 2021 study in the journal iScience that explains what is happening in your knee: Synovial macrophages that are activated by cartilage fragments initiate synovitis, a condition that promotes hypertrophic changes in chondrocytes leading to cartilage degeneration in osteoarthritis. . . Stimulated macrophages promoted hypertrophic changes in chondrocytes resulting in the production of matrix-degrading enzymes of cartilage. So the chondrocytes become bloated with matrix-degrading enzymes of cartilage and puke them out in the knee.
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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.
Everything In The Knee Affects The Ligaments And The Ligaments Affect Everything In The Knee Undetected Micro Ligament Damage Causes Swelling
Ligaments function primarily to maintain smooth joint motion, restrain excessive joint displacement, and provide stability across the knee joint. When the forces to which ligaments are subjected are too great , failure occurs, resulting in drastic changes in the structure and physiology of the joint. In your knee, it is causing a lot of swelling and functional instability.
Above we discussed research that suggested that the patient did not realize how bad their knee was and that is why they had chronic swelling. Knee instability and swelling can be caused by microdamage which causes instability that is not easily seen on MRI and is difficult to determine in a knee examination? Why because when the whole knee is in failure, it is hard to see the little things. Like micro-tearing of the knee ligaments. One thing is easy to see however, that is the result of micro ligament damage also referred to as ligament laxity.
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Inflammation Comes Before Cartilage Breakdown Inflammation Therefore Causes Bone On Bone Not The Other Way Around
Here is what this paper said:
- . . . our results suggest that inflammation of the synovium, which occurs prior to cartilage degradation, is an early event during osteoarthritis initiation and progression.
- Note: Inflammation comes before cartilage breakdown. Inflammation, therefore, causes bone on bone, not the other way around.
What Are The Most Common Causes Of Joint Effusion
There are several reasons why your knee or other joints might swell with fluid. The most common reasons include:
- Infection. An infection in your joint is called septic arthritis. Septic arthritis is a serious disease that can damage or even destroy your joint. You might need a joint replacement a type of surgery because of it. When you have an infection, your joint tissues can fill with pus. Pus is a protein-rich liquid thats full of dead white blood cells.
- Inflammation. This may be from conditions such as arthritis especially osteoarthritis gout or rheumatoid arthritis.
- Overuse. This is when you use a joint too much. For example, running too hard and often might cause your knee to swell.
- Trauma. A ligament injury or a broken bone are examples of trauma that can lead to swelling. Possible causes of such injuries include contact sports and car accidents.
- Tumor. A mass of tissue that might be benign or cancerous.
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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.
Moreover There Are Several Things That Can Cause This Such As Arthritis And Injuries And How To Get Rid Of Fluid On The Knee May Depend On The Underlying Causeotherwise Known As Knee Effusion Water Or Fluid On Your Knees Is A Clear Sign That Something Isn’t Right

16 home remedies to relieve constipation. Is it dangerous to have fluid on the knee? Aug 28, 2017 · knee effusion home remedies and exercises. The following are some home remedies for water on the knee or knee effusions that can be done before getting professional medical. 25 best home remedies for carpal tunnel pain in fingers, hands, & thumb. Castor oil is another very effective one among the best home remedies for bursitis in elbow, knee, hip, and shoulder you can find out there and try at home. 8 natural home remedies for knee pain. Sep 06, 2017 · home remedies for gout in knee. Fourteen home remedies the treatment for knee pain Oct 25, 2018 · this involves taking a small sample of joint fluid from your knee with a small needle and looking at it under a microscope for any uric acid crystals. 14 home remedies for arthritis & joint pain. Castor oil can help to reduce swelling and pain in the joints, according to a study. 12 ways to get rid of gas & bloating
7 natural cough remedies for persistent & dry coughs. 11 home remedies to get rid of canker sores. Is it dangerous to have fluid on the knee? 8 natural home remedies for knee pain. The following are some home remedies for water on the knee or knee effusions that can be done before getting professional medical.
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What Is Joint Aspiration
Joint aspiration is a procedure that sucks fluid from your knee, hip, shoulder, or other joints. Your doctor may do it to help with swelling and fluid related to an injury, infection, or another health condition. Joint aspiration can also help to diagnose arthritis or other joint problems. Your doctor looks at the fluid to find out what type of arthritis you have, like gout or rheumatoid arthritis.
If you have arthritis, bursitis, or tendinitis, getting rid of extra fluid that’s built up inside your joints can help relieve pain and let you move more easily. Sometimes your doctor might inject medicine after the extra fluid is gone. The most common ones are anti-inflammatory corticosteroids.
If you need joint aspiration, your doctor may do other procedures, too. These include:
- X-ray
Understanding An Infused Knee
If you have knee pain or an injury to your knee, swelling may be a factor. Swelling is usually obvious because of the change in your kneeâs appearance. But other signs of knee swelling include discomfort, pain, or loss in your range of motion. â
Knee swelling is often the result of:
- Traumatic injuries like fractures and meniscus or ligament tears
- Infections in your knee, which are rare but can be severeâ
- Overuse of the joint from repetitive movements â
Of all causes, overuse is the most common reason for an infused knee. Fluid buildup is your bodyâs way of protecting the area from extra damage. You may have minor swelling after a vigorous activity. This can also be an early sign of arthritis. If you have persistent swelling, talk to your doctor about your concerns.
An infused knee can happen at the front of your knee, called an anterior injury. It can also happen at the back of your knee, called a posterior injury. Anterior swelling is much more common than posterior because of the way we use our knees for activities.
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Indications Of Knee Aspiration For Therapeutic Purposes Include
- Relieving Tense Effusion When knee swelling is large or tense or pain causes discomfort, drainage of fluid helps to relieve the pressure and pain.2 Reduction in swelling and decreased tension aids in improving joint movement.
- Drainage of Infected Fluid In a known infective condition, drainage of septic effusion can help in providing relief, improve joint movement and prevent damage to the joint.
- Injection of Medications into the Knee Joint Knee aspiration and injection is at times performed to provide relief in joint conditions.3
Research: Patients Do Not Know How Bad Their Inflammation Is Or How Destructive It Is To Their Knees
This is really something that is hard to imagine. The patient does not know how bad swelling is for their knee. Knee osteoarthritis and the eventual development of bone on bone knees do not usually happen overnight. We say usually because there is the phenomenon of rapidly accelerated knee osteoarthritis where a patient can go from stage 1 to stage 4 osteoarthritis in a matter of months or a few years. So even in this rapid stage, bone on bone does not occur overnight. As this is a gradual progression it is easy to stay with the same management routine day after day, month after month, year after year of painkillers, anti-inflammatories, and knee braces. You know all the while your knees are getting worse but you need to work or be a caregiver or do the things you need to do so you manage your knees on a daily as needed basis. On a daily basis, unless there is an acute event, it is difficult to see how your knees are moving forward to a degenerative disease requiring knee replacement.
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