Knee Effusion

Aka: Knee Effusion, Knee Swelling

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II. Causes

  1. Intraarticular Swelling
    1. See Knee Effusion Causes
  2. Extrarticular Swelling
    1. Anterior: Prepatellar or infrapatellar Bursitis
    2. Posterior: Popliteal Cyst
    3. Medial: Pes Anserine Bursitis
    4. Lateral: Iliotibial Band Syndrome

III. Signs

  1. Swollen knee assumes 15-25 degree resting position
  2. Landmarks of anterior knee obscured by fluid
  3. Knee Bulge Sign
  4. Ballottable Patella Sign

IV. Diagnostics: Knee Arthrocentesis

  1. See Monoarthritis or Polyarthritis
  2. See Synovial Fluid
  3. Indications
    1. Arthrocentesis is key to exclude Septic Joint in Acute Monoarthritis
    2. Large, painful Knee Effusion of unclear etiology
  4. Simple clear transudative fluid
    1. Knee sprain
    2. Chronic meniscal tear
  5. Hemarthrosis (Bloody effusion)
    1. Anterior Cruciate Ligament Tear
    2. Osteochondral Fracture (Tibial Plateau Fracture)
    3. Acute meniscal tear
  6. Pustular Drainage
    1. Septic Joint

V. References

  1. Johnson (2000) Am Fam Physician 61(8): 2391-400 [PubMed]
  2. Pendergraph (2026) Am Fam Physician 114(1): 49-62 [PubMed]

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