Diagnostic approach to knee joint effusion

Diagnostic approach to knee joint effusion

1. Aditia K, Ongkowijaya J DIAGNOSTIC APPROACH TO KNEE JOINT EFFUSION

2. INTRODUCTION One of the most complex joint of the human body No gold standard : brief history taking, deep physycal examination + imaging + laboratory test Trauma Vs Non-Trauma Acute vs chronic, local vs systemic manifestation 25% population >55th have knee pain

3. ANATOMY

4. PHYSIOLOGY Synovia fill the joint space (high viscosity  hyaluronic acid) Normal synovial fluid  ultrafiltrate from plasma  less albumin and no fibrinogen Pathological mechanism  increase permeability  high molecule protein and fibrinogen in synovial fluid

5. HISTORY TAKING Trauma or non-trauma Weight berring or non-weight berring When, precipitating factor, age, habbit, past illness, including history of infection Local or systemic Other manifestation

6. PHYSICAL EXAMINATION LOOK MOVEMENT FEEL

7. Identification of Effusion

8. LABORATORY TEST GENERAL Complete Blood Count, Diff Count ESR and CRP Coagulation SPECIFIC Uric Acid ANA and Ds-DNA Blood Culture Urinalysis

9. RADIOLOGY X-RAY MRI ULTRASOUND

10. Rontgen

11. Ultrasound

12. Ultrasound

13. Ultrasound

14. ARTHROCENTESIS

15. JOINT FLUID ANALYSIS

16. JOINT FLUID ANALYSIS

17. Macroscopic

18. Macroscopic

19. Microscopic

20. Microbiology GRAM STAIN CULTURE

21. SUMMARY The knee is one of the most complex joints in the human body and often disrupted Arthrosentesis can be diagnostic and therapeutic To make a proper diagnosis of knee joint effusion requires good history taking , careful physical examination , radiologic and laboratory findings , and arthrosentesis Effusion of the knee joint can occur due to several mechanisms

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