Extensive bruising on the knees and calves

Introduction In patients with traumatic synovitis of the knee, if it is an acute injury, it is characterized by a knee hematoma. Joint hematoma usually occurs within 1 to 2 hours immediately after or after the injury, and there are extensive blood spots in the knee and calf. There is synovial coverage in the joint capsule of the knee joint, which is the largest two synovial cavities in the human body. The synovial membrane is rich in blood vessels, synovial cells secrete synovial fluid, nutrient-free articular cartilage, lubricate the joint surface, reduce friction, and dissipate the heat generated by joint activities. Synovial fluid is a mucin alkaline liquid that prevents the harmful effects of acidic metabolites.

Cause

There is synovial coverage in the joint capsule of the knee joint, which is the largest two synovial cavities in the human body. The synovial membrane is rich in blood vessels, synovial cells secrete synovial fluid, nutrient-free articular cartilage, lubricate the joint surface, reduce friction, and dissipate the heat generated by joint activities. Synovial fluid is a mucin alkaline liquid that prevents the harmful effects of acidic metabolites.

Synovitis is the reaction of the synovial membrane after stimuli, and the imbalance of synovial secretions leads to synovial fluid accumulation. Incentives can generally be divided into two categories: external factors and internal factors. The external factors are mainly mechanical damage such as acute injury or chronic strain (including surgical damage), which is an important factor in the development of traumatic synovitis. Acute traumatic synovitis is a condition characterized by hemorrhage after injury.

Chronic synovitis is generally caused by the failure of acute traumatic synovitis, or by other chronic strains, causing inflammation of the synovial membrane to ooze out of joint effusion. Clinically, it belongs to the scope of syndromes of traditional Chinese medicine. It is a combination of phlegm and phlegm. Or obese people, the blood is injected into the joints and the disease occurs.

an examination

Related inspection

Blood routine

There are two main types of examination for this disease:

(1) Physical examination: examination can be seen in the knees on both sides of the patellar ligament, bulging, full, palpation by hand, the area is soft, even the capsule is sexy, if the joint effusion exceeds 10 ml, the relief test is positive. Knee function tests generally have no obvious positive signs.

(2) X-ray examination: the sacral line examination shows swelling of the joint capsule and swelling of the synovial membrane, and sometimes bone destruction can be seen.

Differential diagnosis

Clinically, it is divided into two cases, namely traumatic inflammation and chronic strain inflammation.

(1) If it is an acute injury, it is characterized by a knee joint hematoma. Joint hematoma usually occurs within 1 to 2 hours immediately after or after the injury, and there are extensive blood spots in the knee and calf. There was tension in the skin or swelling at the time of palpation, and the floating test was positive. Often have systemic symptoms, such as fever caused by blood stasis, local hot. This disease is often a complication of other injuries. Careful examination should be done during clinical practice to prevent missed diagnosis.

(2) Chronic strain or injured knee synovitis, which is caused by improper treatment of acute synovitis, which is more common in the elderly, more physique, or accompanied by knee varus, knee valgus or other Patients with knee deformities, or those with knee joint hyperplasia. Most of the patients complained of severe discomfort in both legs. The knee flexion and extension was difficult, but there was no obvious obstacle in passive exercise. The pain was not severe, the local was not red or hot, and the knee function test generally had no obvious positive signs. The common phenomenon is: bulging and fullness in the knees on both sides of the patellar ligament, palpation by hand, which is soft and even sac sexy. If the joint effusion exceeds 10 ml, the relief test is positive.

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