Joint effusion: what is it and how can it be treated?

Did you know that housewives have joint effusion more frequently and that it is necessary to sleep well to have healthy joints? Discover all this here.

Last update: 09 September, 2022

Joint effusion is called abnormal accumulation of fluid in the joints. This can be synovial fluid, blood, or pus. It can affect one or more joints.

Synovial or joint fluid is a viscous and transparent gel-like substance, rich in hyaluronic acid, lubricin, prostaglandins, proteinase and collagenases. Under normal conditions, it is found in small quantities, as a thin film that acts as a lubricant.

It is, in the same way, a source of nutrients for the structures that make up the joint.

However, in response to trauma, inflammation, or infection, changes in the volume of this fluid occur. So, there we talk about joint effusion.

Joint effusion is a sign or indicator that something is wrong and not a disease itself.

What are the causes of joint effusion?

There are many and diverse causes that can trigger a joint effusion. These are usually divided into traumatic and non-traumatic, as well as those due to local or systemic inflammation.

They can also be classified according to their duration:

  • Treble: less than 6 weeks of evolution.
  • Chronic: greater than this period.

Joint effusion due to local inflammation

When the spill affects a specific area, it is local. In this case, it may be due to trauma and degenerative diseases, such as osteoarthritis. Also diseases such as hemophilia and hemochromatosis.

Joint effusion due to systemic inflammation

If the effusion involves multiple joints, the condition is systemic. The causes of this type of spillage are the following:

Gout has a characteristic presentation with pain and joint effusion in the right big toe.

What are the symptoms of joint effusion?

Joint effusion is accompanied by edema or swelling, pain, redness, warmth, and functional limitation of the joint. Deformities and crepitus or crackling may be noted.

When the origin of the symptoms is inflammatory, it improves with walking and worsens with rest. In contrast, mechanical pain is pain that worsens with movement and improves with rest.

Algias are usually predominantly daytime and do not interrupt sleep. But it should be noted that even without symptoms, joint effusion could be present.

Calderón et al. performed joint ultrasound on 182 asymptomatic volunteers. Their study revealed that some alteration was present in 87% of the cases. In 68.1%, the finding was a joint effusion.

Joint effusion was the most frequent abnormality in both hands and feet.

How is joint effusion diagnosed?

To know the cause of a joint effusion, a thorough history and clinical examination are needed. If the effusion is accompanied by pain, its exact location will be of vital importance, as well as knowing the nature (diffuse/localized, dull/electrifying, irradiated), the moment of appearance (early in the morning, when running, under stress), possible triggers (coughing, sneezing, certain movements), intensity and duration (intermittent, permanent).

For example, in gout, the pain is severe and worse at night and in the morning. Morning stiffness is typical in rheumatoid arthritis.

Laboratory exams

To differentiate between systemic and local inflammatory joint effusions not associated with trauma, several laboratory tests are useful. First, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Both are elevated when the condition is systemic.

Depending on the suspected diagnosis, more specialized studies will be carried out, such as the measurement of blood uric acid, antinuclear antibodies (ANA) and rheumatoid factor. Finally, if this does not achieve an approximation to the diagnosis, fluid will be extracted from inside the joints for a thorough examination.

imaging studies

An arthrography or joint ultrasound is usually the first imaging study indicated. It will be very helpful to distinguish if the problem is inside or outside the joint.

Meanwhile, conventional radiography will serve to rule out fractures, when joint effusion is related to trauma. At the same time, tumors, bone lesions, and degenerative or inflammatory changes can be visualized.

Computed tomography and magnetic resonance imaging will be reserved for cases of difficult diagnosis. Also for complex traumas or non-inflammatory effusions.

How is joint effusion treated?

Treatment of joint effusion will depend on its cause, accompanying symptoms, and the affected joints. Although there are some measures for the home that are recommended, such as rest, local ice, pain relievers and anti-inflammatories, It is best to consult a trusted doctor.

therapeutic arthrocentesis

Arthrocentesis deserves a special mention, a procedure indicated for acute symptoms of joint pain, exacerbation of chronic joint disease or in cases of painful joint effusion due to trauma. The joint space will be entered and the fluid will be aspirated with a needle..

This intervention must be done under sterile conditions and by an experienced doctor. Complications are rare and, if they do occur, are usually not serious.

Arthroscopies are surgical procedures that can be used for diagnosis or to establish therapy at the same time they are performed.

Can joint effusion be prevented?

There are certain factors that favor the appearance of a joint effusion. Consequently, avoiding them is a way to prevent them.

In the study by Calderón et al, older people (51 to 60 years old), engaged in manual labor such as agriculture, gardening, housewives, cargo handlers, plumbers, mechanics, maintenance and General services; with working time of more than 10 years and suffering from diseases such as high blood pressure, diabetes mellitus and hypothyroidism, presented joint effusion more frequently.

~ Rev.Colomb.Reumatol. 2019;26(3):165-176. ~

Another known risk factor for joint problems is being overweight. Losing 5 kilograms of weight or losing 5% of body weight reduces knee discomfort by up to 90%.

Instead, the role of sleep in bone health is less well known, but of great interest. Sleeping few hours or working at night have a negative impact.

The mechanisms proposed to explain this fact range from the acquisition of unhealthy habits, such as disordered eating, to the alteration in the production of hormones and genes that work according to the circadian rhythm.

10 tips to take care of the joints

Here is a decalogue that will help you take care of your bone and joint health:

  1. Maintain an ideal weight and avoid being overweight.
  2. Perform physical activity at least 30 minutes per day.
  3. Prevent injuries that can occur with sports.
  4. Take steps to prevent injuries at work.
  5. Prevent falls.
  6. No Smoking.
  7. Not to drink alcohol.
  8. Sleep well.
  9. Go to the doctor in time if there are symptoms in the joints.
  10. Attend the controls and follow the recommendations of the professional if I suffer an injury.

Do not forget that to know what type of physical activity is suitable for you, and what diet is the healthiest, It is advisable that you consult a health professional.

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