Our legs constantly withstand a huge load - we perform many muscle contractions, flexion and extension of joints every day. Naturally, it is the lower extremities, and especially the knee joints, that are most often exposed to various diseases. And the most common symptom of fatigue, and possibly illness, is an unpleasant burning sensation in the knee joint. However, it can occur in the knee, as well as above it - in the thigh, or below it - in the lower leg or foot. Many factors contribute to the appearance of burning and pain.
A burning sensation in the knee joint is a reaction that occurs during inflammatory, deforming processes, and acute disturbances of blood flow. A feeling of discomfort can appear both from the outside and inside the joint itself. A burning sensation on the skin on the side of the knee is associated with irritation of pain receptors and is observed with burns, frostbite, skin damage, prolonged periods without movement, as well as allergic reactions.
A burning sensation and pain in the knee is the most common symptom of many leg diseases.
Most often the pain appears inside the knee. There are dozens of diseases known in medicine that can manifest themselves as severe pain or a feeling of heat in the legs. The causes of discomfort can be divided into:
Only an experienced doctor can accurately determine the cause of burning in the knee area. The knee is not a part of the body that can be “experimented” on, since it is the knee joint that allows a person to move. Knee pain, both internally and externally, can be a consequence of illness. And only some of them can be gotten rid of with a simple massage and warming ointment. It is also necessary to limit the mobility of the joint, for example, by fixing it with a plaster cast or special bandages.
Congenital and acquired pathologies of bones, cartilage and ligaments are the most common cause of burning in the thigh, on the outside and inside of the knee joint. As a result, itching occurs, as with a pinched nerve. Treatment in such cases consists of a set of therapeutic measures (such as taking courses of physiotherapy and exercise therapy) and regular use of medications. In particularly severe cases, joint replacement surgery is required.
They can be considered a subtype of damage to the musculoskeletal system. Such injuries are characterized by nagging pain, especially after prolonged physical exertion. If you do not consult a doctor for help, there is a risk of developing arthrosis. If you feel a burning sensation or pain in the knee joint, even if it is not severe, give your legs a rest first and take the necessary medications (nimesulide, ibuprofen and ketonol). If you are unable to walk on your leg, have knee swelling, redness, obvious deformity of the knee, and have a fever, you should consult a doctor immediately.
Chamomile decoction will help relieve swelling
Arthritis of the knee joint is a chronic or acute inflammatory lesion of one or both knee joints. This disease entails limited motor activity, acute, severe pain and burning in the joint, and decreased ability to work. Three types of this disease have been identified: osteoarthritis (the gradual deterioration of articular cartilage), post-traumatic arthritis (occurs when ligaments are damaged or other injuries to the knee) and rheumatoid arthritis (an inflammatory process that leads to the destruction of the cartilage of the knee joint).
Varicose veins are a disease of the veins, which results in an increase in their size, a change in shape, and a decrease in elasticity. Manifested by pain and burning in the thigh. The main way to completely eliminate varicose veins is a full-fledged surgical or minimally invasive treatment, which consists of removing dilated veins or sclerotizing them with a laser or chemicals.
If the patient has a nagging pain behind the knee, and there is also slight swelling, then there is a possibility of a cyst. Treatment, in most cases, requires surgery. Rehabilitation therapy will take quite a long time before you can move without any discomfort or pain. Pain behind the knee in adulthood and old age can be triggered by childhood injuries. The area may also be swollen and swollen. In the most unfavorable course, the knee will bend with great difficulty, and you can simply forget about full walking.
It is also a common ailment for athletes – runners. A rupture is possible with a sudden start, as well as with a characteristic injury or mechanical impact on the meniscus. In old age, arthrosis can cause a rupture, which simply destroys the cartilage tissue. Conservative therapy for a meniscus tear is not always appropriate and effective, so surgeons most often come to the rescue. Rehabilitation does not take much time. In addition, traditional medicine can come to the rescue.
Infection of a wound in the ankle or a vein on the inside of the thigh is often the cause of problems with the knee joints. There are lymph nodes under the knee, which are the “guardians” of any organism. Therefore, the infection does not go further and spreads in the knee. In this case, the pain is not behind the knee, but in front. These types of infections are treated with medication.
When undergoing a rehabilitation course after treatment, it is necessary to give maximum rest to the joints for a while.
Sometimes severe itching or a burning sensation in the muscles and skin below or above the knees are not indicators of disease. For example, during pregnancy, many changes occur in the body due to a surge in hormones. In particular, swelling of the legs, which causes compression of the internal vessels, pain in the legs, burning in the knees and hips. In this case, the pain in the legs goes away after childbirth. You can relieve the discomfort by taking diuretics, which will relieve swelling. Women do not require complex treatment; moreover, uncontrolled strong medications can be dangerous for the baby. The most common cause of discomfort is wearing uncomfortable shoes. You just have to choose more suitable shoes and your feet will feel much better.
Constant care of your feet is the key to their health
Hemarthrosis is an accumulation of blood in a joint. Most often develops due to injuries. The second most common disease is hemarthrosis in hemophilia. Hemorrhage can occur in any joint, but in most joints it is usually small and resolves on its own, without special treatment. The exception is the knee joint; if hemarthrosis occurs, special treatment is required in such cases.
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The mechanism of injury can be almost any. Hemarthrosis due to bruises of the knee joint, as a rule, occurs as a result of a fall or (less often) a direct blow. Hemarthrosis due to ligament rupture and meniscal rupture often results from a sports injury. Hemarthrosis with intra-articular fractures can occur either as a result of a normal fall on the knee, or as a result of larger incidents: road traffic accidents or falls from a height. In serious incidents, it may be combined with other injuries: chest injuries, fractures of the spine, pelvis and limb bones, head injury, blunt abdominal trauma and injuries to the genitourinary system.
More or less pronounced accumulation of blood is also characteristic of the postoperative period during various planned surgical interventions on the knee joint, for example, when removing the meniscus, suturing the cruciate ligaments, osteosynthesis of the femoral condyles with screws, osteosynthesis of the tibial condyles with plates or screws. With hemophilia, scurvy and hemorrhagic diathesis, hemarthrosis can develop even after minimal trauma. In some cases, the traumatic impact is so insignificant that the patient cannot even remember it.
In the first degree of hemarthrosis (volume of bleeding up to 15 ml), the joint is slightly increased in volume. Symptoms of the underlying injury (usually a bruised knee joint) predominate. The pain is local in the area of injury, there is no bursting pain in the joint. Support on the leg is free or somewhat limited. In the second degree of hemarthrosis (the volume of blood shed is up to 100 ml), the joint increases in volume, becomes spherical, and its contours are smoothed out. During palpation, fluctuation is determined. With significant accumulation of blood in the knee joint, a noticeable bulge is observed along the anterolateral surfaces outside and inside the patella. With continued bleeding and the third degree of hemarthrosis (the volume of blood shed is more than 100 ml), the skin may become bluish, and the soft tissues may become very tight and tense. In some cases, there is an increase in local temperature.
It is not difficult to completely restore JOINTS! The most important thing is to rub this into the sore spot 2-3 times a day.
Due to the accumulation of blood in the joint cavity, the tissues are compressed, their blood circulation is disrupted, which can become an impetus for the development of dystrophic changes (especially with repeated hemarthrosis). Subsequently, blood cells begin to disintegrate, decay products enter the tissues, and this also has a negative effect on the hyaline cartilage and joint capsule. Hemosiderin (a pigment formed when blood cells are destroyed) accumulates in the tissues, causing the capsule, cartilage and ligaments to become less elastic. Small areas of destruction appear on the surface of the cartilage, the cartilage loses its integrity and becomes less smooth. This, in turn, causes further trauma to the cartilaginous surfaces during movement, which over time can lead to the development of arthrosis.
In some cases, breakdown products of blood cells cause inflammation of the synovium of the joint. The membrane begins to secrete an increased amount of inflammatory fluid, effusion appears in the joint, and aseptic synovitis develops. If pathogenic organisms enter the inflammatory fluid by hematogenous (through the blood) or lymphogenous (through lymphatic vessels), synovitis can become infectious. When the process spreads to the fibrous membrane of the joint capsule and surrounding tissues, purulent arthritis may develop.
The diagnosis of hemarthrosis is made based on clinical data and medical history. In order to exclude bone damage, all patients with suspected hemarthrosis are referred for an X-ray of the knee joint. If necessary (for example, if a ligament rupture or cartilage damage is suspected), other additional studies may be prescribed: CT of the knee joint or MRI of the knee joint, arthroscopy, etc. Suspicion of non-traumatic hemarthrosis is an indication for consultation with a hematologist.
If a person has developed hemarthrosis, then any damage can lead to the accumulation of blood in the joint cavity. This occurs due to the rupture of blood vessels, the main function of which is to supply intra-articular tissues. Blood circulation is gradually disrupted, and the pressure in the joint cavity will increase.
Once blood enters the joint, abnormal changes occur and scar tissue forms. If diagnosis and treatment are not carried out in time, this tissue will begin to accumulate, causing irreversible processes and dangerous consequences for health.
If treatment is untimely and incorrect, the acute stage of the disease will turn into chronic. A secondary infection may also occur. All this provokes the development of purulent synovitis or purulent arthritis.
Depending on the causes of the pathological process, hemarthrosis is divided into traumatic and non-traumatic.
The main reason for its development is a bruise or injury to a certain joint. When falling on the knee or due to a direct blow to it, hemarthrosis of the knee joint develops. For a more accurate formulation of the diagnosis, the location of the process is also taken into account. For example, the medical history indicates hemarthrosis of the right or left knee joint. In most clinical situations, it is the right joint that suffers, since it is the supporting joint for many people. Often when people fall, they rely on their right leg or right arm.
Hemorrhage may occur due to a sports injury. Most often, a ligament or meniscus tear occurs. Such injuries are more common in athletes involved in gymnastics, strength sports and running sports.
An intra-articular fracture is also a common cause of hemarthrosis of the knee or elbow joint.
During planned operations on joints, hemorrhage into the joint cavity may also occur. In most cases it is minor and does not pose a threat to human health. But if blood does get into the joint cavity, then after surgery the doctor monitors the patient’s condition for some time.
This type of pathology develops when a person has pathologies associated with blood clotting disorders:
Blood vessels rupture and blood fills the joint cavity. In most clinical situations, it is hemophilia that causes hemorrhage in the joint. The disease affects people of all ages and is also diagnosed in children. With hemophilia, blood can fill not one joint cavity, but several at once, which is very dangerous for health and requires adequate and timely treatment.
Hemarthrosis in medicine is divided into three degrees, depending on the severity of symptoms:
There are several characteristic symptoms of hemarthrosis of the elbow, hip or knee joints:
It is important to notice these symptoms in time in order to refer the patient to medical care. institution for providing qualified assistance.
Diagnosis of hemarthrosis of the right or left knee or elbow joint is carried out on the basis of data obtained during a medical examination, as well as during additional examination. The most effective methods are:
If there is a suspicion of hemophilia, the doctor may prescribe the patient for a consultation with a hematologist, geneticist or other specialists.
A description of hemarthrosis of the knee, elbow and ankle joint is included in the international directory of classification of diseases. It combines all diagnostic information. In ICD 10, hemarthrosis has code M25.0.
Codes are necessary for storing information data and making it easier to process. The diagnostic and clinical terminology used in the Russian version of the medical reference book corresponds to domestic practice.
Hemarthrosis of the knee, elbow or ankle joint can develop as a result of various injuries:
Symptoms of the disease are more pronounced in children. Therefore, immediately after an injury, the child should be seen by a doctor. Traumatic hemarthrosis of the knee, elbow or ankle joint is characterized by the presence of a certain clinical picture:
Symptoms of post-traumatic hemarthrosis of the ankle, knee and elbow joints develop within 1.5-2 hours.
Important! To prevent hemarthrosis, people should, if possible, try to avoid traumatic situations, wear fixing bandages, and promptly treat chronic diseases.
To prescribe adequate treatment, the doctor must be confident in the correctness of the diagnosis. For this purpose they prescribe:
In order to exclude infectious inflammation, arthritis and to determine signs of hemarthrosis, a puncture of the cavity of the joint capsule is performed. The presence of blood in the test indicates the presence of hemarthrosis of the ankle, knee or any other joint.
Note! Chronic hemarthrosis of the knee joint is a very dangerous disease. Untimely treatment of the pathology threatens the patient with multiple complications.
Treatment of the disease consists of removing blood exudate from the joint cavity. After this, the capsule is washed with saline and medications are injected into the cavity to eliminate bleeding, inflammation and pain.
Hemarthrosis in the primary stage is quite easy to cure. The treatment procedure is carried out under local anesthesia, in the following order:
This procedure can be performed several times.
Using the puncture method, hemarthrosis of the knee joint can be cured in three weeks. If hemorrhage into the joint cavity recurs, degenerative changes occur. Therefore, curing secondary hemarthrosis is much more difficult. If the disease reappears, another method is chosen for surgery:
When using this technology, the risk of recurrent bleeding is significantly reduced, so the disease can be cured with one procedure. With mild bleeding, the joint fluid resolves on its own and does not require surgery. In such a situation, the symptoms of hemarthrosis of the knee or ankle joint can be eliminated with folk remedies.
You can use absorbable compresses (arnica and wormwood herbs, clay), take anti-inflammatory infusions (nettle, yarrow), and pain-relieving honey ointments. After an injury, the limb must be ensured complete rest; the leg or arm must be in an elevated state.
Cold should be applied to the area of the injured joint for two days. The load on the affected joint should be limited.
Hemarthrosis of the first degree:
swelling in the joint area and slight swelling;
the volume of hemorrhage does not exceed 15 ml;
Supporting the leg is slightly difficult, but is possible and is not accompanied by attacks of severe pain.
Hemarthrosis of the second degree:
the volume of hemorrhage into the joint does not exceed 100 ml;
the joint takes on the shape of a ball, its volume increases significantly;
when you feel the joint, you can identify the presence of blood clots in it;
there is severe pain.
Hemarthrosis of the third degree:
the volume of hemorrhage into the joint exceeds 100 ml; in most cases, such changes are caused by a dislocation or fracture;
the skin in the joint area acquires a bluish tint, soft tissues become tense and hard;
in some cases, the skin becomes hot to the touch and the overall body temperature rises;
it is almost impossible to support the leg.
It is customary to distinguish two types of hemarthrosis: non-traumatic and traumatic.
The main cause of the development of pathology is bruise or injury to the joint. When a knee joint is bruised, hemorrhage usually occurs after a fall on the knee, a little less often in the case of a direct blow. Also, hemorrhage into the joint is possible when receiving a sports injury (for example, when a meniscus or ligament ruptures) - athletes who engage in strength and running sports (football, gymnastics, karate, wrestling, handball, basketball) are susceptible to such injuries. One of the reasons for the development of hemarthrosis may be an intra-articular fracture, which also occurs during falls that injure the joint, as well as during falls from a height, road accidents, and unsuccessful landings during a parachute jump. Quite often, such injuries cause serious consequences, for example, traumatic brain injuries, chest injuries, broken arms, legs, and spine.
Minor hemorrhage into the joint cavity may appear during a planned operation on the joint, for example, during suturing of the cruciate ligaments, osteosynthesis of the tibia with plates, or removal of the meniscus. In such cases, during the rehabilitation process after surgery, the attending physician must monitor the condition of the joint.
Hemarthrosis of non-traumatic origin occurs when a person has diseases that are associated with blood clotting disorders (hemorrhagic diathesis, scurvy, hemophilia) and fragility of the vascular walls. In this case, blood vessels can rupture even in the absence of a pronounced impact and fill the joint cavity with blood.
In the presence of this pathology, blood begins to accumulate in the joint cavity. Blood clots begin to compress neighboring tissues, which provokes poor circulation in them, resulting in disruption of normal tissue trophism. Blood cells break down, and their breakdown products begin to penetrate into neighboring tissues, reducing the level of elasticity of the latter. Among other things, the hyaline cartilage also suffers, and the ligaments lose their elasticity. During movement, the load on the cartilage tissue increases significantly, which provokes further destruction and the development of arthrosis.
Another complication is synovitis - this is inflammation of the synovial membrane, which is accompanied by the accumulation of fluid in the joint cavity. Synovitis is divided into infectious and aseptic, depending on the mechanism of development. Post-traumatic synovitis usually has a long course (more than two months). This pathology is quite difficult to treat; in addition, there is a high probability of recurrence within several months or years.
In cases where the fibrous membrane of the joint capsule is damaged, purulent arthritis begins. This disease develops when an infection joins the blood that fills the joint. The joint tissue begins to envelop pus, after which the cartilage is damaged, which leads to a significant decrease in the motor activity of the joint.
After bruises, dislocations, or joint injuries, a person experiences severe pain and consults a traumatologist. In the presence of significant hemorrhage (more than 50 ml), it is possible to palpate to determine the presence of blood clots in the joint. Almost always, the doctor prescribes an x-ray of the joint in order to get a complete picture of the damage the patient has sustained. Hemorrhage into the joint is always suspected, so diagnosing this condition is not difficult. If there is suspicion of cartilage damage or ligament rupture, arthroscopy and computed tomography of the joint are performed. In the presence of non-traumatic hemarthrosis, consultation with specialized specialists is required.
If you receive an injury to your shoulder, elbow, pelvis, or knee, you should contact a traumatologist as soon as possible. Of course, it is not always possible to get to a doctor in a matter of minutes, so you need to take primary measures to prevent possible complications. First aid for the development of hemarthrosis includes the following actions:
Provide the victim with complete rest and immobilize the damaged joint to prevent additional stress on it. It is better to move the sore limb into an elevated position (for example, press your arm to your body, place your leg or shoulder on a pillow), which will reduce swelling;
apply an iodine mesh to the damaged area - this will reduce swelling;
apply cold to the joint - ice wrapped in a towel or rag, a heating pad with cold water.
First of all, the doctor will determine the degree of hemarthrosis in order to estimate the approximate volume of blood collected in the joint. Treatment for first-degree hemarthrosis is usually limited to the application of an immobilizing plaster bandage, since a blood volume of no more than 15 ml usually resolves on its own, therefore there is no need for a puncture to deposit blood from the articular cavity. Ice is applied to the joint and the load is reduced, and physiotherapy is prescribed - UHF.
Treatment of second-degree hemarthrosis consists of the following measures:
If the volume of spilled blood in the joint exceeds 25 ml, it is necessary to perform a puncture to pump out the blood from the joint. The puncture is performed under local anesthesia. Blood from the joint cavity is removed through a needle, after which the cavity is washed with a novocaine solution (for children - 5-10 ml of a 1% novocaine solution with 50 mg of hydrocortisone, for adults - 20 ml of a 2% novocaine solution). After this, the joint is immobilized using a plaster cast.
After 1-2 days, a repeat diagnosis is performed: if blood accumulates in the joint, a repeat puncture is performed. Typically, therapy for hemarthrosis consists of 1-2 punctures, but in rare cases 3-4 manipulations may be required.
The joint requires complete rest. If there is hemarthrosis of the knee joint, it should be kept on a pillow and moved with the help of crutches.
After 10-12 days, physical therapy is prescribed, which includes simple movements in the joint, light massage, physiotherapy (paraffin therapy, ozokerite, baths). The plaster cast is removed. The next two weeks are aimed at intensifying joint loads and gradually restoring normal functioning. Restoring the functioning of the joint is well promoted by proper nutrition: seeds, nuts, tea with raspberries and currants activate the process of joint regeneration, while spicy and fatty foods, on the contrary, slow down this process.
Third degree hemarthrosis is usually preceded by serious trauma. The patient must be hospitalized and undergo an additional in-depth examination: determination of the degree of blood clotting, consultation with a hematologist, MRI, arthroscopy of the knee joint. During arthroscopy, damaged pieces of the meniscus and cartilage are removed, and intra-articular damage is corrected.
When, as a result of injury, the joint has been severely damaged or completely fragmented, puncture will not have the desired effect. In such severe cases, the only effective solution is joint replacement - replacing a severely damaged joint with an artificial one. This operation is not cheap, but in world medical practice, endoprosthetics as a treatment option for hemarthrosis is quite often used and shows good results.
With traumatic hemarthrosis, the prognosis is quite favorable, although much directly depends on the severity of the injury. The faster qualified medical care is provided, the lower the risk of relapses and complications of this pathological condition.
Hemarthrosis in the presence of hemophilia, along with the standard treatment regimen, is also accompanied by a blood plasma transfusion, and intravenous administration of antihemophilic globulin is also required. Treatment of hemarthrosis in such cases is performed in a hematology department. Since hemorrhage into the joint with this disease quite often develops again, the prognosis regarding the preservation of the full range of functions of the joint is rather uncertain.
Avoiding joint injuries: observing safe work practices at work, wearing special clothing and shoes by athletes and workers.
When you receive a joint injury, it is extremely important to provide proper first aid and, if possible, take a drug to increase blood clotting, which will significantly reduce the volume of blood spilled into the joint cavity.
In case of hemorrhagic diathesis, scurvy, hemophilia, it is necessary to undergo routine medical examinations with the attending physician.
Hemarthrosis is a joint pathology in which hemorrhage occurs in its cavity. Hemarthrosis is a consequence of damage to joint tissue, which can occur against the background of general health due to injury or as a consequence of illness with minor mechanical impact. A disease in which hemarthrosis is the main symptom is hemophilia. When blood vessels are damaged, blood flows into the joint, the joint capsule is stretched, which causes pain and impairs the function of the joint. But the main danger of intra-articular bleeding is its long-term adverse effect on the health of cartilage tissue and ligaments. The most common type of hemarthrosis is hemarthrosis of the knee joint, since the knee is most susceptible to injury and has a rather complex structure.
When injured, acute pain occurs in the joint area, an increase in its volume and loss of function. The pain intensifies as bleeding continues, due to stretching of the joint capsule. There is fluctuation on palpation. The skin over the joint is tense, may become bluish, and the local temperature may rise. At the same time, there may be fragments of cartilage in the joint (fractured menisci, chipped heads of cartilage), so after removing blood from the joint cavity, the pain may intensify or change its character.
If treatment is not carried out, blood permeates the cartilage tissue and forms clots, which then undergo fermentation. These processes disrupt the integrity and smoothness of cartilage tissue, which becomes the basis for the development of degenerative and inflammatory processes in the joint. With repeated hemorrhage into the joint, the process of dissolving blood clots by enzymes occurs more intensively.
In hemophilia, bleeding into the joint may initially be hidden. During the first two years of the disease, bleeding appears in the villi of the synovial membrane of the joint; they are saturated with lymphocytes and plasma cells. Small blood clots form in the joint and hemosiderin is deposited. These processes lead to the development of fibrous changes in the joint, which reduces the elasticity of ligaments, cartilage tissue, joint capsule, etc., and increases the susceptibility to injury and repeated hemorrhages. Hemophilia should be diagnosed at an early age for timely preventive measures.
It is recommended to remove blood from the joint cavity as soon as possible. To do this, a puncture is used, washing the joint, after which medications are injected into the joint cavity to reduce pain and relieve inflammation.
The puncture is carried out under the influence of local anesthetics, for example a 5% novocaine solution. A hollow needle is inserted into the joint cavity and the blood is sucked out with a syringe. This is the classic method and the most common. After suctioning the blood, a drug of blood clotting factors should be injected into the joint to stop bleeding and prevent its resumption. Intra-articular administration of 2% novocaine (pain relief), hydrocortisone, Kenalog (anti-inflammatory effect) is also recommended. The final stage consists of tight bandaging, applying a circular pressure bandage, followed by immobilization with a plaster cast. The method has the main drawback that at the moment of blood extraction with a syringe, conditions are created for increased or renewed bleeding, since negative pressure is created in the joint cavity. In this case, the extraction of blood from the joint will always be incomplete, and conditions are created for the development of antigenic activity and damage to cartilage and ligaments by antibodies. The effectiveness of such treatment is much higher if the case of hemarthrosis is the first. Such patients usually recover completely without recurrence of hemarthrosis. In case of repeated cases of hemorrhage into the joint, the effectiveness decreases, since the cartilage tissue and ligaments, as a rule, have already undergone degenerative changes.
Another method of puncture of the knee joint is aimed at reducing the likelihood of creating negative pressure in the joint cavity, which significantly reduces the likelihood of resumption of bleeding. To do this, the bulk of the blood is first sucked out of the joint, after which the medicine is injected through the same puncture for rinsing, and it is removed using a new puncture and another needle. Thus, during the main period of manipulation, two needles are simultaneously present in the joint. At the time of fluid extraction, the joint is compressed from the outside with an elastic circular bandage. Positive pressure is created inside the joint by creating a greater rate of fluid inflow than its outflow. When the flowing liquid is completely free of blood, the outflow needle is removed, and another amount of the required medicine (at the doctor’s choice) is injected through the inflow needle. The final stage consists of applying a pressure bandage and immobilizing the joint.
If a case of hemarthrosis occurs in a patient with hemophilia, immediate intravenous administration of antihemophilic globulin and blood plasma transfusion are also necessary.
The main requirement when performing a joint puncture is complete asepsis, since there is a high risk of complications of hemarthrosis with a bacterial infection and the development of purulent inflammation, which can lead to chronic arthritis. In some cases, in connection with this, intra-articular antibiotics are also used (often with repeated punctures).
In the first week after puncture of the knee joint, you cannot lean on the sore leg; you should use crutches. Then the plaster cast is replaced with a knee brace, which should be worn for up to six months, depending on the effectiveness of restoring joint function. During the recovery period, a course of exercise therapy is recommended.
In case of injuries with the formation of cartilage fragments, relapses of hemarthrosis are possible due to secondary damage to the vessels by solid particles during the development of the joint. The presence of crushed cartilage is an indication for arthroscopy and surgical removal. Such operations must be carried out strictly in a specialized hospital by a qualified surgeon. To clarify the diagnosis, an X-ray examination in several projections and magnetic resonance imaging are performed. MRI provides comprehensive data on damage to joint structures.
For complex joint lesions, multiple relapses, and as a consequence of chronic inflammatory and degenerative joint diseases, knee replacement is used.
The joints of the legs and arms ensure the normal functioning of the limbs and are actively involved in walking, running and sports activities. The knee joint is the weakest and most prone to injury.
Traumatologists note that even slight pain in the knee joint during its extension and flexion needs to be paid attention to.
Pain in the knee during extension may appear due to age-related changes; they are characterized by a decrease in the amount of joint fluid, as well as worn-out articular surfaces. Knee pain is the most common reason why people consult a doctor of this profile.
The knee joint is quite large, and, nevertheless, it is the weakest from an anatomical point of view. The joint is surrounded by leg muscles, which strain it during extension and flexion.
Due to regular exercise, rheumatoid arthritis can develop, which manifests itself as pain in the knee joint.
Only a doctor can perform a competent diagnosis of the inflammatory process. Since the knee joint is large, the doctor must palpate it and perform a puncture. When the knee does not straighten, this is also a good reason to consult a doctor.
The manifestations of knee pain during extension and flexion may be different. The specifics of its treatment directly depend on the cause of the disease.
Leg injury during sports is the most common cause of pain. As a rule, teenagers, mostly boys, are injured. Most often, one knee is affected. As a rule, only one knee suffers.
Knee pain can be caused by bursitis, or in other words, inflammation of several joint capsules in the joint. The following symptoms of bursitis exist:
The above are the most characteristic symptoms of the condition, but there is another cause of pain in the knee when bending - sciatica or inflammation of the sciatic nerve.
Sciatica appears as a result of wearing long and narrow boots, so symptoms of inflammation of the sciatic nerve are most often diagnosed in women. If knee pain occurs when bending, it means that the branches of the nerves under the skin were pinched.
Among other things, the cause of pain can be tendinitis of the knee joint. As a result of excessive activity when walking, cycling or skiing, irritation of several or one tendon begins. We are talking about tendons that support the connection of the human knee joints when the ligaments are very tense.
Even bending the knee slightly can cause pain and discomfort. These symptoms are not particularly common in people with normal physical activity.
Pain may indicate the presence of a Baker's cyst of the knee joint or fluid accumulation under the knee. Typically, the problem is a hernia in the knee, a torn meniscus in the leg, or damaged cartilage.
If you do not seek help in a timely manner, a blood clot will appear, which poses a great danger to life. It is important that surgery is performed urgently. The accumulation of fluid causes severe knee pain, even when the legs are straightened.
Another cause of pain is patellofemoral syndrome, which causes discomfort in the area of the kneecap. The pain in the leg becomes worse if it remains at rest for a long time (for example, when sitting for a long time).
To relieve leg pain, you should perform a set of exercises that will maintain muscle tone. You need to put a heating pad with ice on your knee 2-3 times a day, and also change your regular shoes to more comfortable models.
Hemarthrosis is bleeding into a joint. It occurs due to rupture of blood vessels supplying blood to intra-articular structures. Most often observed in the knee joint. May be traumatic or non-traumatic. Traumatic hemarthrosis always develops with intra-articular fractures and often accompanies milder injuries (tears and ruptures of ligaments, meniscus tears, joint bruises). Non-traumatic hemarthrosis can appear in diseases associated with blood clotting disorders or increased fragility of the vascular wall - with scurvy, hemophilia and hemorrhagic diathesis. With hemarthrosis, the joint increases in volume and becomes spherical, pain and fluctuation (swelling) occurs. The diagnosis is made based on examination. To clarify the cause of hemarthrosis, radiography, MRI, CT and other studies may be prescribed. Treatment is joint puncture and application of a plaster cast.
If hemarthrosis is caused by a bruise or is non-traumatic in nature (due to hemophilia, scurvy, etc.), the patient complains of moderate bursting pain in the joint, especially pronounced when a large amount of blood is poured out. Support on the leg is possible, movements are somewhat limited. In case of hemarthrosis caused by more severe injuries (torn ligaments or meniscus tears, fractures), symptoms characteristic of a particular injury are revealed. So, if the ligaments are damaged, instability of the joint will be observed, a fracture will cause severe pain, and support on the leg will be impossible, etc.
In the absence of timely treatment, a small amount of blood in the joint may resolve on its own. With severe hemarthrosis, the blood subsequently becomes more liquid, causing the swelling in the joint area to “soften.” The joint seems to float, the bulges along its lateral surfaces “slide” downwards when the body position changes. Along with this, the formation of clots is possible, which in some cases can be felt under the fingers when palpated.
If symptoms of hemarthrosis appear, you should go to the emergency room as soon as possible in order to receive timely treatment and prevent the development of complications. At the prehospital stage, it is necessary to provide rest to the limb by placing it on a horizontal surface with a small pillow under the knee joint. You can apply cold to the joint (a heating pad with cold water or an ice bag wrapped in a towel).
With the first degree of hemarthrosis, puncture is not performed, since such an amount of blood resolves on its own. A plaster splint is placed on the leg, it is recommended to apply cold for 1-2 days, maintain an elevated position of the limb and limit the load. Subsequently, UHF is prescribed. The duration of immobilization depends on the underlying injury.
If the amount of blood in the joint exceeds 25-30 ml, a puncture is necessary. The puncture is performed under local anesthesia. First, a thin needle is inserted along the outer lateral surface of the joint, just below the patella, to numb the soft tissues and capsule. Then the needle is changed to a special one, thicker and longer. The blood is removed, the joint cavity is washed with novocaine. If necessary, hydrocortisone or triamcinolone is administered. Then a tight bandage is applied to the joint and immobilization is performed with a splint. Sometimes blood accumulates in the joint again, so a repeat examination is scheduled after 1-2 days. If necessary, the puncture is repeated. Usually 1-2, less often 3 punctures are enough. An elevated position of the limb and walking on crutches is recommended. The period of immobilization, as in the previous case, is determined by the underlying injury.
Hemarthrosis of the third degree, as a rule, accompanies severe injuries. In such cases, patients are hospitalized in the trauma department and treated for the underlying injury. Punctures are performed as blood accumulates in the joint. If third-degree hemarthrosis occurs in the absence of severe injuries, this is also a reason for hospitalization in the trauma department. Along with standard treatment measures, in such cases a detailed examination is carried out: determination of blood clotting, MRI, CT, examinations of other specialists, etc.
Persistently recurrent hemarthrosis is also an indication for in-depth examination, since repeated accumulations of blood may be due to cartilage damage that is not visible on radiographs. Typically, in such cases, the patient is referred for arthroscopy of the knee joint - this therapeutic and diagnostic method allows not only to clarify the cause of repeated bleeding, but also, in some cases, to carry out all the necessary therapeutic manipulations. For example, remove damaged pieces of cartilage or a torn part of the meniscus.
Hemarthrosis in hemophilia, along with standard treatment measures, requires blood plasma transfusion and intravenous administration of antihemophilic globulin. Treatment is carried out in the hematology department.
The prognosis for traumatic hemarthrosis is usually favorable, especially in case of timely access to a medical institution. Recurrent hemarthrosis, as well as hemarthrosis in severe injuries and hemophilia, can cause complications and the subsequent formation of arthrosis of the knee joint.