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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 prepatellar bursa and the olecranon bursa are the two bursae that are most likely to become infected, or septic. [10] Septic bursitis typically occurs when the trauma to the knee causes an abrasion, though it is also possible for the infection to be caused by bacteria traveling through the blood from a pre-existing infection site. [11]
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.
X-ray of the knee of a 12-year-old male, with knee effusion extending into the suprapatellar bursa.. In front, there are five bursae: the suprapatellar bursa or recess between the anterior surface of the lower part of the femur and the deep surface of the quadriceps femoris. [2]
The suprapatellar bursa, the largest bursa, extends the joint space anteriorly and proximally. The subpopliteal recess and semimembranosus bursa are located posteriorly and are much smaller; The lateral and medial subtendinous bursae of gastrocnemius are located at the origin of the two heads of the gastrocnemius muscle. Non-communicating bursae:
Intermittent hydrarthrosis (IH), also known as periodic synoviosis, periodic benign synovitis, or periodic hydrarthritis, is a chronic condition of unknown cause characterized by recurring, temporary episodes of fluid accumulation in the knee.
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Healthy bursae create a smooth, almost frictionless functional gliding surface making normal movement painless. When bursitis occurs, however, movement relying on the inflamed bursa becomes difficult and painful. Moreover, movement of tendons and muscles over the inflamed bursa aggravates its inflammation, perpetuating the problem.