Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentPreventionWhen to See a Provider
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Prevention
When to See a Provider
Joint effusionis swelling of the tissues in or around your joint because of extra fluid. Joint effusion can cause a “puffy” appearance to your joints along with symptoms like pain and stiffness. Common causes of joint effusion are infections, arthritis, or injury (includingrepetitive use injuries).
When the buildup of fluid comes withinflammationof the connective tissues lining a joint, it is called joint effusion withsynovitis.
Joint effusion tends to affect larger joints such as the knee (sometimes called “water on the knee”), shoulder, elbow, or ankle. However, this is not the same asedema, which is the generalized build-up of fluid in tissues.
This article explains what joint effusion is, its causes and symptoms, and how it can be treated.
Verywell / Emily Roberts
Joint Effusion Symptoms
Regardless of what is causing the accumulation of fluid in a joint, the symptoms are more or less the same. They can range in severity from mild to debilitating.
Classic symptoms of joint effusion include:
Depending on what is causing joint effusion, there can also be other symptoms like:
When Is Joint Effusion an Emergency?
You needemergency care for a swollen joint if:
What Causes Joint Effusion?
Joint effusion is a sign of joint inflammation and can be classified as either infectious (septic) or noninfectious (aseptic).
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Infection
An infection in the bloodstream (systemic infection) can sometimes take hold in a joint and cause swelling and effusion in just that area (localized).
Signs of Septic Arthritis
Certain factors increase the risk of septic arthritis, including:
Injury
Injury is a common cause of joint effusion, especially in the knees.Injuries from a car accident, severe fall, or blunt force impact can lead to an effusion.
These injuries can also involve bone, connective tissues (such astendonsandligaments), or joint cartilage (like themeniscus). Repeated stress on a joint can also cause effusion. This type of overuse injury happens when a person is repeating a movement a lot and for a long time, and is usually related to an occupation or sports.
Pain, swelling, stiffness, and trouble extending or rotating the joint are other common symptoms of injury-related effusion.
Arthritis
Joint effusion is common in people with arthritis. The condition can bechronic(comes on slowly and is progressive) oracute(comes on fast and is severe).
There are two main categories of arthritis:osteoarthritis(a non-inflammatory form of arthritis that’s also called “wear-and-tear arthritis”) andautoimmune arthritis(a group of inflammatoryautoimmune disordersin which the immune system attacks its own joints).
With osteoarthritis, joint effusion most commonly occurs when there is extensive joint damage. The knee is the joint that is most often affected.
With autoimmune arthritis, joint effusion can be chronic but most often occurs in acute episodes (exacerbations or “flare-ups”). Some autoimmune conditions that can cause joint effusion are:
Joint Effusion Diagnosis
Diagnosing joint effusion may involve a physical exam, imaging tests, and a lab evaluation of the fluid in your joint. In addition, a healthcare provider will want to talk to you about your medical history, current health, and other symptoms.
Physical Examination
Your provider will look at your joint carefully. They will touch (palpate) and work (manipulate) the joint to determine the severity of the condition and the possible causes.
Here are some things your provider might notice during the exam:
Imaging Tests
After examining your knee, a provider may order imaging tests to see what’s causing the effusion. Each test has its benefits and limitations.
The imaging tests may include:
Joint Fluid Analysis
Your provider may want to drain (aspirate) fluid from a swollen joint. This can help reduce pressure and relieve pain but can also provide valuable information about the cause of the effusion.
The fluid (synovial fluid) is removed with a needle and syringe during a procedure known asarthrocentesis. Synovial fluid is usually clear with the consistency of an egg white. Any changes in the appearance, texture, color, or composition of the fluid can provide clues about what might be causing the effusion in the joint.
A lab can analyze the fluid to determine if there are excesswhite blood cells(a sign of infection),uric acid crystals(a sign of gout), or other abnormalities that may narrow the possible causes.
What Is Involved in Synovial Fluid Analysis?
How Is Joint Effusion Treated?
The standard first-line treatments for joint effusion include rest,ice application, immobilization, and anonsteroidal anti-inflammatory drug (NSAID)like Advil (ibuprofen) or Aleve (naproxen).
If the swelling is severe, your provider may want to aspirate the joint to reduce pressure. They may give you acortisone injectionafter the procedure to reduce inflammation and pain.
Infections can usually be treated with a 14-day course of a broad-spectrum oralantibioticlike ciprofloxacin. Serious infections likesystemicgonorrheaormethicillin-resistantStaphylococcus aureus(MRSA), may require a two- and four-week course of intravenous (IV) antibiotics.
If you have rheumatoid arthritis or another form of autoimmune arthritis, medications can be prescribed to suppress the overactive immune response and relieve symptoms. Examples of these medications areimmunosuppressive drugslike methotrexate orHumira (adalimumab).
Home Remedies for Joint Effusion
Treating Joint Effusion With RICE Therapy
While joint effusion cannot always be avoided, there are things you can do to significantly lower your risk of it occurring:
When to See a Healthcare Provider
Seek emergency care if you have signs of infection or injury along with the swelling. These symptoms include fever, redness around the joint, skin hot to the touch, and inability to move your joint or to put weight on it.
If you have a swollen joint without signs of an emergency, call your healthcare provider. They can have you come in for an appointment to find out what’s causing the joint swelling and make sure you get the right treatment. If they’re not sure, they might refer you to another provider who specializes in joints, like a rheumatologist or orthopedist.
Summary
Joint effusion is extra fluid around a joint. It tends to affect larger joints, such as the knee or ankle. A joint effusion can occur as a result of injury, infection, or arthritis.
Your provider might be able to drain the excess fluid to relieve your symptoms while they work on finding out the cause or wait for treatments (like antibiotics or immunosuppressants) to start working. Making some changes to your hobbies and lifestyle can also help you manage joint effusion.
How to Get Rid of Fluid on the Knee
18 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Wang X, Jin X, Blizzard L, et al.Associations between knee effusion-synovitis and joint structural changes in patients with knee osteoarthritis.J Rheumatol. 2017;44(11):1644-1651. doi: 10.3899/jrheum.161596Gupte C, St Mart JP.The acute swollen knee: diagnosis and management.J R Soc Med.2013 Jul;106(7):259–68. doi:10.1177/0141076813482831Frush TJ, Noyes FR.Baker’s cyst: Diagnostic and surgical considerations.Sports Health. 2015;7(4):359-65. doi:10.1177/1941738113520130Londe P, Guttridge DC.Inflammation induced loss of skeletal muscle.Bone. 2015 Nov;80:131–42. doi:10.1016/j.bone.2015.03.015Long B, Koyfman A, Gottlieb M.Evaluation and management of septic arthritis and its mimics in the emergency department.WestJEM. 2019;20(2):331-41. doi:10.5811/westjem.2018.10.40974Ridley U, Ridley L.Imaging of the knee: Common acute presentations to general practice.Aust J Gen Pract. 2020;49(6):344-349. doi: 10.31128/AJGP-10-19-5120Pathria MN, Chung CB, Resnick DL.Acute and stress-related injuries of bone and cartilage: pertinent anatomy, basic biomechanics, and imaging perspective.Radiology. 2016;280(1):21-38. doi:10.1148/radiol.16142305Lespasio MJ, Piuzzi NS, Husni ME, Muschler GF, Guarino A, Mont MA.Knee osteoarthritis: a primer.Perm J. 2017;21:16-183. doi:10.7812/TPP/16-183Centers for Disease Control and Prevention.Rheumatoid arthritis.Vaidya B, Bhochhibhoya M, Nakarmi S.Synovial fluid uric acid level aids diagnosis of gout.Biomed Rep.2018;9(1):60-64. doi:10.3892/br.2018.1097Centers for Disease Control and Prevention.Childhood arthritis.Mease PJ, Gladman DD, Papp KA, et al.Prevalence of rheumatologist-diagnosed psoriatic arthritis in patients with psoriasis in European/North American dermatology clinics.J Am Acad Dermatol. 2013 Nov;69(5):729-35. doi: 10.1016/j.jaad.2013.07.023MedlinePlus.Synovial fluid analysis.Kabat GC, Kim MY, Manson JE, et al.White blood cell count and total and cause-specific mortality in the Women’s Health Initiative.Am J Epidemiol. 2017;186(1):63-72. doi: 10.1093/aje/kww226Ragab G, Elshahaly M, Bardin T.Gout: An old disease in new perspective – A review.Journal of Advanced Research. 2017;8(5):495-511.Patel DR, Villalobos A.Evaluation and management of knee pain in young athletes: overuse injuries of the knee.Transl Pediatr. 2017;6(3):190–198. doi:10.21037/tp.2017.04.05Martin CL, Browne JA.Intra-articular corticosteroid injections for symptomatic knee osteoarthritis: What the orthopaedic provider needs to know.J Am Acad Orthop Surg.2018. doi:10.5435/JAAOS-D-18-00106Choi YJ, Ra HJ.Patient satisfaction after total knee arthroplasty.Knee Surg Relat Res. 2016;28(1):1–15. doi:10.5792/ksrr.2016.28.1.1
Wang X, Jin X, Blizzard L, et al.Associations between knee effusion-synovitis and joint structural changes in patients with knee osteoarthritis.J Rheumatol. 2017;44(11):1644-1651. doi: 10.3899/jrheum.161596
Gupte C, St Mart JP.The acute swollen knee: diagnosis and management.J R Soc Med.2013 Jul;106(7):259–68. doi:10.1177/0141076813482831
Frush TJ, Noyes FR.Baker’s cyst: Diagnostic and surgical considerations.Sports Health. 2015;7(4):359-65. doi:10.1177/1941738113520130
Londe P, Guttridge DC.Inflammation induced loss of skeletal muscle.Bone. 2015 Nov;80:131–42. doi:10.1016/j.bone.2015.03.015
Long B, Koyfman A, Gottlieb M.Evaluation and management of septic arthritis and its mimics in the emergency department.WestJEM. 2019;20(2):331-41. doi:10.5811/westjem.2018.10.40974
Ridley U, Ridley L.Imaging of the knee: Common acute presentations to general practice.Aust J Gen Pract. 2020;49(6):344-349. doi: 10.31128/AJGP-10-19-5120
Pathria MN, Chung CB, Resnick DL.Acute and stress-related injuries of bone and cartilage: pertinent anatomy, basic biomechanics, and imaging perspective.Radiology. 2016;280(1):21-38. doi:10.1148/radiol.16142305
Lespasio MJ, Piuzzi NS, Husni ME, Muschler GF, Guarino A, Mont MA.Knee osteoarthritis: a primer.Perm J. 2017;21:16-183. doi:10.7812/TPP/16-183
Centers for Disease Control and Prevention.Rheumatoid arthritis.
Vaidya B, Bhochhibhoya M, Nakarmi S.Synovial fluid uric acid level aids diagnosis of gout.Biomed Rep.2018;9(1):60-64. doi:10.3892/br.2018.1097
Centers for Disease Control and Prevention.Childhood arthritis.
Mease PJ, Gladman DD, Papp KA, et al.Prevalence of rheumatologist-diagnosed psoriatic arthritis in patients with psoriasis in European/North American dermatology clinics.J Am Acad Dermatol. 2013 Nov;69(5):729-35. doi: 10.1016/j.jaad.2013.07.023
MedlinePlus.Synovial fluid analysis.
Kabat GC, Kim MY, Manson JE, et al.White blood cell count and total and cause-specific mortality in the Women’s Health Initiative.Am J Epidemiol. 2017;186(1):63-72. doi: 10.1093/aje/kww226
Ragab G, Elshahaly M, Bardin T.Gout: An old disease in new perspective – A review.Journal of Advanced Research. 2017;8(5):495-511.
Patel DR, Villalobos A.Evaluation and management of knee pain in young athletes: overuse injuries of the knee.Transl Pediatr. 2017;6(3):190–198. doi:10.21037/tp.2017.04.05
Martin CL, Browne JA.Intra-articular corticosteroid injections for symptomatic knee osteoarthritis: What the orthopaedic provider needs to know.J Am Acad Orthop Surg.2018. doi:10.5435/JAAOS-D-18-00106
Choi YJ, Ra HJ.Patient satisfaction after total knee arthroplasty.Knee Surg Relat Res. 2016;28(1):1–15. doi:10.5792/ksrr.2016.28.1.1
Gupta C, St. Mart J.The acute swollen knee: diagnosis and management.J Royal Soc Med.2013; 106(7):259-68. doi:10.1177/0141076813482831
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