Swelling, limited mobility of the knee joint along with subcutaneous hematomas - these symptoms are often observed after injury. A disease that is accompanied by hemorrhage into the joint cavity is called hemarthrosis. How to properly treat this disease and what rules to follow to avoid worsening?
Most often, hemarthrosis is diagnosed in winter - during icy conditions.
What are the causes of hemarthrosis
Most often, the disease results from a bruise, dislocation or subluxation, rupture of a ligament or meniscus. Trauma leads to damage to the blood vessel - blood enters the cavity. This happens, for example, when falling while skating or skateboarding, if the athlete does not use knee pads, as well as in everyday life - even when going down the stairs unsuccessfully.
Very rarely, the cause of hemarthrosis is a blood disease, such as hemophilia or hemorrhagic diathesis, as well as other coagulation pathologies.
First aid
If the knee is swollen without bruising and is very painful, then you must immediately make an appointment with an orthopedist to determine the cause of the pathological condition. Doctors do not recommend that patients take analgesics, NSAIDs, diuretics, or use anti-inflammatory ointments or gels before consultation. This significantly distorts the clinical picture and complicates diagnosis. It is advisable to improve well-being in case of acute pain syndrome or in the absence of the possibility of quickly seeing a doctor. What to do in such cases:
- lie down, avoid any static or dynamic loads;
- elevate the sore leg by placing it on a bolster or pillow;
- for severe pain, take a tablet of Nise, Ketorol, Ibuprofen.
Cold compresses are used to eliminate swelling. Fill a plastic bag with crushed ice, wrap it in thick cloth, and apply it to the sore joint for 10 minutes. The procedure should be performed every hour until the swelling resolves. Orthopedists recommend applying a bandage to the knee by wrapping an elastic bandage around it several times. The joint should not be overly compressed - this will only increase the severity of swelling due to pinching of the blood vessels.
Ice compress.
Symptoms
If the volume of blood spilled into the joint capsule is small, there may be no external signs at all. A person only experiences pain and discomfort - by analogy with the treatment of arthrosis or osteoarthritis of the knee, and is also forced to limit mobility. External symptoms appear if more than 40-50 ml of blood has spilled into the cavity:
- the joint swells and increases in volume;
- bruises are noticeable;
- It becomes very painful to move your leg.
Knee swelling? Fix the limb and go to a rheumatologist-orthopedic surgeon
Symptoms
Depending on the source of the problem, the swelling process may manifest itself in the following signs:
- If the cause of swelling is gout or arthritis, then the swelling is accompanied by pain in the joint and nearby muscles.
- Psoriatic arthritis can be recognized not only by swelling, but also by red spots that appear throughout the body. Also, the skin often becomes covered with scales, and the joints on the fingers of the limbs swell.
- Septic arthritis is accompanied not only by swelling, but also by fever.
- Bursitis reveals itself not only by swelling, but also by redness. Often the skin becomes hot to the touch and pain occurs.
- If the cause of pain is injury, then the pain syndrome will manifest itself not only during movement, but also in a calm state.
Subtleties of diagnosis
Often, an external examination is sufficient to diagnose hemarthrosis. The doctor will palpate and make sure that the patella is balling. Such a “floating” patella is never detected with ordinary bruises.
A puncture of the knee joint will help confirm the presence of blood in the cavity, but it is not enough to understand the nature of the damage. Therefore, patients are prescribed additional examination - MRI, CT or ultrasound.
How does blood get into the joint capsule? Expert - about the mechanism of development of hemarthrosis:
Inflammation of the sciatic nerve
A serious problem with the occurrence of a tumor above the knee is inflammation of the sciatic nerve, which significantly limits the patient’s movements. Inflammation is often caused by reasons: cold, leg injury, viral infection. More often, inflammation appears as a result of hypothermia.
The sciatic nerve originates in the sacral spine; the disease occurs if a person’s back is blown in cold weather, in a draft. Inflammation is expressed in swelling and swelling of the leg above the knee, the patient experiences severe pain in the indicated area, the temperature rises, and redness of the skin is possible. On the opposite side of the body, the patient feels numbness or tingling.
As a rule, the pain intensifies when coughing, sneezing, or physical activity. At night, the patient experiences severe attacks of pain that interfere with rest and limit movement.
Treatment tactics for hemarthrosis
First of all, it is necessary to quickly remove blood and synovial fluid from the cavity through puncture. The procedure is carried out under local anesthesia under aseptic conditions, after which special drugs are administered orally - anti-inflammatory, analgesic and hemostatic. Sometimes, as in the treatment of osteoarthritis of the knee, arthroscopy may be necessary if the damage to the internal structures is large.
If the blood volume is less than 20-30 ml, you can do without a puncture: the clots will gradually dissolve on their own. If the manipulation is carried out, the patient is given a pressure bandage, and the joint is immobilized using a plaster or splint. For a week, it is recommended to use crutches to walk so as not to rely on the affected leg. At the end of this period, as in the treatment of arthrosis, rehabilitation measures are indicated - physiotherapy, massage and exercise therapy.
The doctor will decide whether a puncture is necessary. It all depends on the volume of blood in the joint cavity
Why do joints swell?
Rheumatoid arthritis
One of the most common types of arthritis is rheumatoid arthritis.
A distinctive feature is bilateral symmetrical damage to the joints. Pathology often debuts against the backdrop of changing seasons, hormonal changes, general infection, injury, and hypothermia. It manifests acutely or subacutely, and subsequently becomes chronic. Possibly a primary chronic course. Joint swelling is accompanied by pain, local hyperemia, hyperthermia, transient or permanent stiffness, and dysfunction. There are special forms of the disease - Felty's syndrome and juvenile arthritis. Felty syndrome develops on average 10 years after the first symptoms of the seropositive form of the disease appear. Damage to small joints in the arms and legs is observed. Hepatosplenomegaly, leukopenia, myocarditis, episcleritis, polyserositis are detected.
Juvenile rheumatoid arthritis develops in childhood or adolescence, resembles the pathology in adults, but differs from it in some ways. Predominant damage to the joints is possible, combined with pronounced systemic manifestations. The process often involves the large joints of the arms and legs. In addition to swelling, deformities and gait disturbances are detected. Sometimes hernial protrusions form.
Other aseptic arthritis
Diseases often occur chronically with alternating exacerbations and remissions. Swelling of the joints is combined with pain, stiffness of movement, and signs of local inflammation. The symptom is detected in the following types of arthritis:
- Psoriatic.
Possible asymmetric oligoarthritis, rheumatoid-like lesions, involvement of the distal joints of the hands. Swelling develops some time after the appearance of skin changes; less often, joint symptoms precede skin symptoms. - Gouty.
In the vast majority of cases, the first metatarsophalangeal joint is affected. The disease begins acutely with sharp pain, swelling, redness of the skin, and dysfunction. Subsequently, attacks gradually become more frequent. Migrating pain, mono- and oligoarthritis of large joints or hands are less common. - Reactive.
1-4 weeks after the onset of symptoms of a urogenital or intestinal infection, asymmetric swelling of the joints occurs. In the typical course (Reiter's syndrome), symptoms of urethritis and conjunctivitis are noted. Skin changes, lymphadenitis, and damage to internal organs are possible.
Swollen joints
Infectious arthritis
They are provoked by specific or nonspecific pathogenic microflora. Along with swelling, pain, redness, local hyperthermia, they are often accompanied by general symptoms: fever, chills, weakness, weakness, intoxication syndrome. The following types of infectious arthritis are distinguished:
- Nonspecific purulent.
Bacterial arthritis usually affects one large joint of the leg: knee, hip, ankle. The swelling increases and is combined with sharp jerking pains, general hyperthermia, and other signs of inflammation. Rapid destruction of the articular surfaces is possible. - Viral.
Swelling and pain are moderate or minor, migrating. Symptoms persist for several weeks or months, with a favorable outcome. - Fungal.
Develops against the background of immune disorders. There is a tendency to a long course, destruction of nearby bone, the formation of fistulas, and the formation of ankylosis. - Gonococcal.
The ankle, knee, elbow joints, and sometimes the hands swell. Multiple rashes appear on the skin and mucous membranes. Manifestations of urogenital infection (urethritis, cervicitis) may be smoothed or absent. - Syphilitic.
It is observed in both congenital and acquired syphilis. A symmetrical lesion of both knee joints and recurrent synovitis are revealed. Dactylitis may form with swelling and subsequent deformation of the fingers. - Tuberculous.
It occurs chronically and affects one of the large joints of the arm or leg. The swelling is initially mild, but subsequently progresses due to synovitis and the formation of cold abscesses. - Brucellosis.
The swelling is small, accompanied by short-term pain. There are pronounced symptoms of an infectious disease: fever, heavy sweats, chills, enlarged lymph nodes, liver, and spleen.
A complication of nonspecific or gonorrheal arthritis involving surrounding tissues is panarthritis. The pathology is accompanied by significant swelling of the joint, a symptom of fluctuation due to the accumulation of pus in the tissues, fever, a drop in blood pressure, and sometimes disturbances of consciousness.
Allergic arthropathy
Pain and swelling of the joints (usually minor) appear immediately after contact with the allergen or after a few days. Combined with skin rash, rhinitis, conjunctivitis, lymphadenitis, broncho-obstructive syndrome, and other manifestations of allergies. Swelling of the joints in some cases is detected with Quincke's edema in children. It is considered a permanent sign of allergic sepsis, which is also more often diagnosed in pediatric patients.
Arthropathy in infectious diseases
Arthropathy due to parasitic and infectious diseases is typically characterized by mild swelling and unstable symptoms that quickly subside with treatment of the underlying pathology. Swelling of the joints can be observed in diseases such as:
- Rubella.
The joints are involved symmetrically. - Parotitis.
The symptoms are similar to rheumatoid arthritis. - Chicken pox.
One or more joints swell for a short time. - Meningitis.
Swelling appears a week after the onset of the disease, one knee suffers, and polyarthritis is less common. - Viral hepatitis.
Swelling of the knees and hands precedes the development of jaundice. - HIV infection.
The knees and ankles are most often affected; swelling is associated with severe pain and limited movement.
Arthropathy in endocrine pathologies
Joint changes develop against the background of endocrine diseases or normal age-related changes. Occurs in the following cases:
- Climax.
Knees and feet are more likely to swell in overweight women. Stiffness, pain, and crunching are observed. - Diabetes.
The feet are affected, less often the knee and ankle joints, and even less often the hands are affected. The swelling occurs due to edema and progressive deformity. - Hyperparathyroidism.
Acute mono- or polyarthritis with short-term swelling of the joints is typical. - Hypothyroidism.
Large joints of the legs suffer. Swelling, joint and muscle pain are detected.
Other arthropathies
Swelling can occur due to intestinal diseases, vasculitis, taking certain medications, inflammation due to the formation of calcifications:
- Intestinal diseases
. Nonspecific ulcerative colitis and Crohn's disease are sometimes accompanied by swelling and other symptoms of arthritis of the legs. - Vasculitis
. Swelling of the joints and transient pain are observed with Wegener's granulomatosis, Henoch-Schönlein disease, Kawasaki disease, and Behçet's syndrome. - Hydroxyapatite arthropathy.
Calcium hydroxyapatite deposits form in the periarticular tissues. One or more joints are involved. Swelling and pain are minor. - Drug-induced arthropathy.
Develops with the use of NSAIDs, glucocorticoids, and anti-tuberculosis drugs. The location, severity of swelling, and the presence of other symptoms depend on the type of drug.
Arthrosis
For the initial stages of arthrosis, swelling is uncharacteristic; it occurs only during periods of exacerbation, and is more pronounced with the development of synovitis. As the process progresses, the swelling becomes permanent; changes in the contours of the joint are caused not only by swelling of the soft tissues, but also by bone deformations. The symptom is clearly visible with arthrosis of the knee joint, damage to the hands with the formation of Heberden and Bouchard nodes.
Injuries
The following traumatic injuries are accompanied by swelling of varying degrees:
- Injury.
The swelling is small, local, short-term. The contours of the joint are not changed, the functions of the leg or arm are preserved, some limitation of movements is possible. - Ligament damage.
The joint swells mainly in the projection of the damaged ligament. Bruises are also found there. The degree of edema increases in direct proportion to the severity of the injury. Functions are limited and instability may occur. - Dislocation.
The contours of the joint are grossly disrupted, movements are impossible, and function is lost. The patient experiences very intense pain. With a fresh dislocation, deformation visually predominates; in the absence of medical care, swelling quickly progresses. - Intra-articular fracture.
Diffuse swelling is accompanied by very sharp pain, deformation, and inability to support. Sometimes crepitus and pathological mobility are detected.
Hemarthrosis often occurs due to trauma. Due to the accumulation of blood, the joint becomes swollen and spherical. The swelling is diffuse, soft-elastic or elastic. Fluctuation is determined.
Other reasons
Swelling of the periarticular area is accompanied by the following pathologies:
- Soft tissue diseases
: bursitis, tendinitis, tendovaginitis, enthesopathies. - Parasitoses
: dracunculiasis, chinga. - Hematological diseases
: sickle cell anemia.
Local swelling of the wrist joint occurs with hygroma, and of the posterior surface of the knee - with Becker's cyst. Swelling and deformation are also detected in neoplasms originating from bone and cartilage tissue. May be caused directly by neoplasia, reactive inflammation, synovitis.
Why is hemarthrosis dangerous?
If blood is not removed from the cavity in a timely manner, the disease can cause complications. Blood saturates the joint and clots form in it. Even if they resolve over time, adhesions may remain in their place - the cartilage surface is deformed and will no longer be smooth. Due to unevenness, the cartilage in certain areas will wear away - sooner or later treatment for arthrosis will be required.
And if in case of hemarthrosis the problem can be solved by puncture followed by rehabilitation, then in case of osteoarthrosis, long-term therapy will be required, for example, an annual course of intra-articular injections of Noltrex. Injections of this synthetic drug relieve pain for 9-15 months, replacing the missing synovial fluid. They must be done at regular intervals to maintain results. Today this is one of the most effective ways to combat arthrosis. If hemarthrosis is treated in time, the knee can remain healthy.
Another danger of this disease is purulent arthritis. Since pathogenic bacteria multiply especially intensively in the blood, there is a high risk of infection. That is why do not ignore a swollen knee: consult with an orthopedist and follow all the instructions for hemarthrosis that are likely to help you avoid arthrosis.
Which doctor should I contact?
If you or someone close to you has swollen joints in the elbows, fingers or toes, knees or ankles, you should definitely consult an orthopedic doctor or rheumatologist. The Center for Rehabilitation Medicine in Naberezhnye Chelny sees specialists with many years of experience working with patients with joint problems. Detailed information about the doctor's qualifications can be found here.
After a thorough diagnosis, the doctor draws up a medication treatment program and prescribes a course of therapy aimed at restoring joint function. The patient finds himself in the capable hands of experienced massage therapists, physiotherapists, and rehabilitators. Thorough training with specialists guarantees a long-lasting therapeutic effect and normalization of damaged joints.
Prices for treatment procedures at the clinic can be found here. If you have any questions, call +7. Attentive specialists will definitely give you a complete answer and make an appointment for a consultation with a doctor at a time convenient for you.
Osteomyelitis
Osteomyelitis is a serious cause of severe pain in the legs above the knee. Let's look at the disease in detail. Osteomyelitis is the process of inflammation of the leg bone when an infection enters the bone tissue. The infection enters the human body in two ways: the first - during a leg injury (for example, an open fracture), the second way - penetration from an already existing inflamed focus of infection in the body (sore throat, caries).
Inflammation of the leg bone
Initially, it is impossible to recognize osteomyelitis in a patient; at the initial stage, there are practically no symptoms, and a little later the disease develops rapidly. At first, the symptoms that appear can be easily confused with a cold; there is weakness and general malaise. The patient suddenly feels increased body temperature, rises to 40 degrees in a few hours, after a few days the person develops obvious signs of osteomyelitis: severe pain occurs in the affected bone, a little later swelling and redness of the skin on the damaged surface of the leg appear.
Osteomyelitis is a disease that requires immediate hospitalization of the patient; in 25% of cases the disease ends in death.
- Why do the leg muscles above the knees hurt on the inside and outside?