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An effusion - one jump too much

C. A. V. Nogueira, M.D. |
You went to that basketball game, you jumped very elegantly up to the sky, but you fell down not so elegantly - on your knee. The next day you couldn't tell the difference between your knee and the ball. And it hurts like hell - that's because you have water on the knee.

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Your knee is very delicate and balanced mix of bones, muscles and other tissue that, working together in harmony, allows you to walk. The cavity in knee joint contains about a teaspoon of a special fluid that serves as a lubricator. That egg white fluid prevents friction between bones and it allows the smooth movement of the knee while you are bending or straighten up.

This fluid is called "synovial fluid" and the membrane which produces is we call "the synovium" or the "synovial membrane". Now, if you irritate your knee, that membrane can start to produce too much of the fluid and that condition is called "an effusion" (or water on the knee). You can irritate your knee with some trauma (like falling on the ground), long-lasting activity (for example, playing basketball on a regular basis), and there also some diseases that can cause too much fluid to be produced (some of them are arthritis, infection, gout, cysts, bleeding disorders or tumours).

There are three risk groups. First, people older than 55. Second, people who practice sport. People who love sports with sudden and strong changes of direction, basketball in the first place, are more likely to get the injury that causes water on the knee. Third, the knees in fat people suffer from tremendous pressure on the knee joint. This increases the risk of osteoarthritis which causes an effusion.

There are three symptoms that point to an effusion. The first is swelling, when one knee is visible larger than another. If there is stiffness, in other words, you can't bend or straighten your knee, that can mean that your knee is full of fluid that prevents normal motions. And in addition to these two, if your knee hurts - especially when you stand on your feet - you're almost sure that you have water on the knee.

What you can do at your home? You can help yourself with rest and ice. Rest will relieve the pressure on your knee, and ice on your knee, 15 to 20 minutes every two to four hours, will relieve the pain and swelling.

Now, when you should see the doctor? If cold bandages and over the counter medications don't relive the swelling and the pain - you should see the doctor. If your knee is red and warm when you touch it - you must see the doctor. Your M.D. will take a bit of fluid from your knee to see what's going on: if the fluid contains crystals you maybe have gout. If there are bacteria then you obviously have an infection and if an infection is left untreated it can destroy the joint. If there is blood too, well, that means that you played that basketball too hard - it's trauma.

Your doctor will prescribe you anti-pain medication, antibiotics if you have an infection, or corticosteroids. These anti-inflammatory drugs can be taken orally or may be injected into your knee. They can cause serious side effects, so they shouldn't be used for a long time. X-ray and magnetic resonance imaging can also be done if something's unclear.

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