What is the danger of bursitis of the knee joint and how to treat it?
It is in these areas the surrounding tissue can be displaced relative to each other. Bursa, as well as the glenoid cavity, lined with a special synovial sheath — they often communicate with each other.
Only in the region of the knee joint there are about eight major burs — four of them are located to the articular cavity is closest. This infra-, supra - and prepatellar bags in the upper and lower part of the knee, over the kneecap , located on the inner lower region of the knee.
One form of bursitis "goose" bags are called Baker's cyst, infrapatellar bursitis — "knee jumper".
Bursitis of the knee symptoms
Clinic bursitis — symptoms of the inflammatory process:
- increased local temperature,
- external small deformation and, as a consequence, limited movements.
As a result of inflammation in the cavity of the Bursa is accumulated exudate — liquid. The composition of exudate depends on the causes of disease and parasite — purulent in bacterial infection, serous in aseptic inflammation (autoimmune disease), hemorrhagic fluid mixed with inflammatory cells — for traumatic injuries.
Symptoms expressed is the impact of localization to become inflamed bags. At the clinic you can immediately determine which of the cavities involved in the pathological process. So, suprapatellar bursitis of the knee joint can be characterized by severe pain and swelling in the upper region of the knee. Goose — manifested after walking up or down stairs especially. In prepatellar bursitis there is a feeling of stiffness (after prolonged kneeling). Unpleasant feeling disappears after a moderate walk.
For acute form is characterized by an abrupt onset and rapid increase of symptoms, soreness, especially when you try to perform any movement in the knee joint or at the moment of feeling the lesion. Pain radiating to hip and ankle joints, respectively, on the same side. The site of the lesion is visible to the naked eye swelling, redness.
Acute bursitis usually has history of injury (three to four hours ago). It is very important as soon as possible to begin treatment to avoid infection. Upon accession bacterial flora in marked deterioration of General condition, temperature rise.
If the treatment was not effective or was not taken to its logical conclusion — developing a chronic process. Chronic bursitis may be the result of a long course of effects of external (professional) conditions — for example, vibration.
For chronic pathology the characteristic change of exacerbations and remissions, sluggish the process. In the period of relapse appear all the symptoms typical of acute bursitis. Such a condition is dangerous to the formation of cystic formations. Chronic bursitis may require surgical intervention puncture to remove accumulated exudates with subsequent washing bags antibacterial solutions.
In light of the prevalence of specific infections we should also highlight tuberculous bursitis. The cavity wall thickening, in the study it is possible to detect the lumps. Looks like swelling up to ten centimeters in diameter, while motor function is not impaired, the movements are not accompanied by painful sensations. The patient noted General malaise, fever, usually in the evening.
With regards to the calcareous bursitis pathology differs relapsing. Usually salt deposits provoke the development of inflammation. After the attenuation process, the escalation is possible in the case of trauma or infection. To cure a bunion, you need to remove lime liquid from the cavity and rinse it thoroughly.
Bursitis klassificeret by the following features:
- The prevalence of the process. Within one region can be affected by several bags;
- . There are acute, chronic and recurrent. Acute or subacute process can be after an injury or infection. Chronic bursitis triggered by a long slow inflammatory process, often of non-infectious nature. Recurrent bursitis are characteristic of tuberculosis;
- For the microorganism. Aseptic processes cause serous bursitis, bacteria — purulent. Purulent-hemorrhagic disease — the result of post-traumatic hemorrhage, complicated by the accession of infection;
- Isolated calcareous bursitis, accompanied by the deposition of salts in the cavity of the Bursa and its walls.
The causes of bursitis of the knee:
- The trauma of the joint, and bags. Shock, drop, external compression of tissues leads to damage of the ligament apparatus and the menisci. Inflammation in this case develops as a reactive process. When hemorrhage into the cavity of opportunities for the accession of pathogenic microflora, which can penetrate a variety of ways (e.g., through the blood —called hematogenous or skin damage). After infection develops purulent-hemorrhagic bursitis.
- Sport. To the development of bursitis may lead a healthy lifestyle. Heavy overload during the occupation of professional sports (most often football, weightlifting), lead to the ligamentous system, the muscular tendons, respectively, the forced deformation of the joint capsule and bags.
- Arthritis, infection.
- Gout. Gout leads to the violation of metabolic processes, manifested by the deposition of salts in different tissues, resulting in inflammation of the joint. Inflammation is able to spread to neighboring Bursa associated with the joint cavity.
- Autoimmune diseases are characterized by the development of inflammation due to the fact that the body perceives its own tissues and organs as foreign and tries to destroy them. Bursitis can also develop as a consequence of autoimmune disease.
- Part of bursitis is formed, for unknown reasons (or rather, not detected during diagnostic examinations at the request of the patient to the hospital).
Prepatellar bursitis of the knee occurs most often because of the frequent trauma to this area, inflammation acts as a protective mechanism. The greater the severity of injury and the more often they occur the more serious the illness until the formation of an abscess in advanced cases. In this area even swollen Bursa can be palpated.
Suprapatellar bursitis of the knee — a disease of people whose profession is associated with prolonged stay on his knees. In the upper region of the knee joint can be felt the tumor with clear margins is inflamed Bursa.
Infrapatellar bursitis, which is often referred to as "jumper's knee" (the same as tendonitis of the patellar tendon, in fact, pathology go hand in hand), occurs when damage to the ligament apparatus. Normally, the Bursa is filled with synovial fluid — this is due to its main function (amortization). Excess external pressure of an unsuccessful jump, the excess weight provokes hemorrhage within the cavity of the bag and triggers the inflammatory process.
Is usually intermittent pain with prolonged standing, and the emergence of a small swelling in the knee region.
"Crow" bursitis — diseases of women in the category between 35 to 45 years old, and people with excess weight. High stress on the joints leads to small injuries of tendons and ligaments. The main feature — pain occurs when you move up the stairs.
Treatment of bursitis of the knee joint in the acute form usually done by a conservative, except in cases of serious injury, when the cavity is necessary to remove a significant amount of blood.
The conservative method consists of the following items:
- provision of complete rest to the injured limb;
- using bandages with pressure;
- physiotherapy: laser, magnetotherapy;
- cold ice compresses;
- ointment (non-steroidal anti-inflammatory , hormonal agents, warming the cream), their application is possible only on holistic skin;
- supplementation of anti-inflammatory action ;
- the use of corticosteroids .
In the absence of effect from treatment for three weeks it is necessary to change the tactics this fact attests to the complication of the process or inadequate therapy.
How to treat bursitis of the knee upon suspicion of joining a secondary infection? Prescribe antibacterial agents in the form of intravenous injection or into the cavity of the Bursa.
For these purposes, use broad-spectrum antibiotics, duration of use up to ten days. With the defeat of several bags, be sure to use steroid preparations.
To determine whether specific infection requires seeding the fluid taken from the oral bags with puncture. Appropriate drugs for tuberculosis process — streptomycin, with gonorrhea — penicillin, etc.
According to the indications: detoxification therapy, pain management, General strengthening means.
Treatment of bursitis of the knee joint in the chronic form, requires the removal of exudate from the cavity of the Bursa with such lavage medicinal solutions to a complete cure.
Surgery about bursitis of the knee
When necessary surgery?
Changed cystic cavity with a concomitant pain syndrome, formation of an abscess, not amenable to antibiotic therapy is an indication to excise the cavity.
Require opening with subsequent drainage of all suppurative forms of bursitis.
Exhausting for calcareous bursitis with frequent exacerbations, the reason for the puncture and aspiration of fluid with calcareous sediments.
The progress of the operation:
Usually performed under local anesthesia. Excise tissue Bursa or enter the cavity through the puncture hole, depending on the process. Most often removes the top wall of the bag. The cavity is treated with antibiotics, antiseptics.
The patient was observed from two hours to several days.
How is the treatment of bursitis of the knee at home? The most popular folk remedies:
- on the inflamed area apply a sheet of fresh cabbage, top with bandage, leave overnight;
- effective poultice with the crushed leaves Kalanchoe, aloe, fresh leaves of lilac;
- a warm bath with pine extract for twenty minutes is a great anti-inflammatory and local distracting effect;
- inside to improve circulation take grapefruit juice.
- the elimination of all inflammatory processes in the body;
- gradual strengthening of the ligament apparatus of the lower extremities;
- waiver of jerks during sports, heavy physical exertion;
- weight control;
- elevated probability of injuries — protection of the knee joints with special devices;
- to avoid low temperatures in the specified area;
- in need of finding a in position "on his knees" — every hour to complete a workout.
Folk remedies are effective only in the early stages of the acute process, preferably immediately after the injury. Purulent and running pathology is treated only under medical supervision!
Preventive measures are:
With the correct tactics, adherence to medical recommendations, the full rehabilitation the prognosis is favorable.
In order to avoid chronicity of the process necessary to carry out the treatment until complete recovery, signs of which are not only eliminating pain, but also the ability to perform active movements in the knee joint.
In some cases, the elimination of risk factors (occupational hazards): vibrations, mechanical stress, prolonged monotonous positions.
The forecast also depends on at what stage treatment is begun. Running form at least increase the likelihood of complications and reduce the chance of the return of the joint in full form from the point of view of the function.
Damage mild not necessarily require medical intervention. However, with the accession of the symptoms of the disease and difficulties in diagnosis treatment of to a specialist is necessary.
Rehabilitation and prevention
Rehabilitation is to restore the former mobility of the joint. For these purposes:
- physiotherapy techniques;
- medical-gymnastic exercises.
Recovery usually occurs within several weeks. From physiotherapeutic procedures are actively using electrotherapy, heat treatments. Effective short wave diathermy, ultrasonic treatment. To reduce the severity of pain used electrophoresis with novocaine.
In chronic bursitis of the knee joint shown sanatorium-resort treatment, hydrogen sulfide and radon baths.
An important place is given to rehabilitation exercises. Physical therapy is best done under medical supervision or after training specialist. In any case, do not include in the program of squats, leg scissoring.
Useful moderate static load. Put it under the joint area with a small towel, try slowly, without jerks and strain the muscles located on the anterior femoral surface. Hand feel muscle tension at the time reduction. Lock the specified position for 5-10 seconds, then slowly relax it. Repeat up to ten times, when the pain immediately stop the exercise, to ensure peace.