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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 approach to diagnosis depends on the joint involved. While aspiration of the joint is considered the gold standard of treatment, this can be difficult for joints such as the hip. Ultrasound may be used both to verify the existence of an effusion and to guide aspiration. [2]
3D image showing normal bursa (left) and bursitis (right)Bursitis commonly affects superficial bursae. These include the subacromial, prepatellar, retrocalcaneal, and pes anserinus bursae of the shoulder, knee, heel and shin, etc. (see below [broken anchor]). [1]
Patellar subluxation syndrome is an injury involving the kneecap.Patellar subluxation is more common than patellar dislocation and is just as disabling. [1]In this condition, the patella repetitively subluxates and places strain on the medial restraints and excessive stress/tension on the patellofemoral joint.
Prepatellar bursitis is an inflammation of the prepatellar bursa at the front of the knee. It is marked by swelling at the knee, which can be tender to the touch and which generally does not restrict the knee's range of motion.
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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]
It seems to affect slightly more women than men. Episodes of swelling last several days or longer, can occur with regular or semi-regular frequency, typically one or two episodes per month. Between periods of effusion, knee swelling reduces dramatically providing largely symptomless intervals.