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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 .
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.
Removing this excess material via lavage frequently resolves arthritic knee inflammation or pain. [2] Arthroscopic lavage is one of many procedures available to help reverse the damage of early arthritis. There is, however, controversy about the value of simple lavage and debridement for the older patient with established osteoarthritis. [3]
Synovial fluid examination [3] [4]; Type WBC (per mm 3) % neutrophils Viscosity Appearance Normal <200: 0: High: Transparent Osteoarthritis <5000 <25: High: Clear yellow Trauma <10,000
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.
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The pressure inside the joint cavity drops and the dissolved gas suddenly comes out of solution and takes gaseous form which makes a distinct popping noise. To be able to crack the same knuckle again requires waiting about 20 minutes before the bubbles dissolve back into the synovial fluid and will be able to form again. [4]
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