Inflammation of the articular bag of the knee joint. Bursitis of the knee joint - a complete description of the disease, symptoms and treatment Surgical treatment of chronic bursitis of the knee joint danger

Knee bursitis is an inflammatory process that affects the synovial bursa of the knee.

The bursa is a small pocket that contains a small amount of fluid.

Synovial bags are located at the junction of the tendon and muscle, so they are responsible for reducing the load on the joint.

Near the knee joint there are 3 synovial bags and each can be inflamed, and this can be both bursitis and synovitis

Types and causes of development

Depending on the type of synovial bag, it is customary to distinguish between synovitis and bursitis of several types:

Suprapatellar (infrapatellar) bursitis of the knee joint - this type is also called popliteal bursitis, since it develops in the popliteal synovial bag. The reasons for the development of this species are tendon injuries in the area under the knee.

Baker's cysts - The onset of a Baker's cyst can indicate both synovitis and bursitis due to the similarity of symptoms. However, this type of bursitis develops on the inside of the lower side of the knee and quite often the disease affects obese people.

Prepatellar bursitis - bursitis of the knee joint of this type are most common. The development occurs in the synovial patella bag, and the causes are in various injuries and injuries of the patella.

Despite the fact that synovitis and bursitis are similar in the initial phase of their development, the causes of bursitis are based on:

Frequent knee injuries
high load on the knee joint,
infectious diseases that affect the bursa,
small bruises, wounds and abrasions near the synovial bag.

Separately, it is worth mentioning the development of the so-called goose foot bursitis. Here, the inflammatory process does not affect the entire articular bag of the knee joint, but only a separate area.

Most often, goose foot bursitis develops in older people, as it is a complication of deforming osteoarthritis of the knee joint.

Much more rarely, goose foot bursitis can be diagnosed in younger people.

In medical practice, goose foot bursitis is rarely used, it is synonymous with anserine bursitis, which is how this disease is designated.

Returning to young people, most often goose foot bursitis is diagnosed in athletes or in people who are forced to work in an uncomfortable position for the knee.

In addition, anserine bursitis is opened against the background of:

diabetes,
meniscus tear,
knee arthritis.
flatfoot,
obesity.

Symptoms

Symptoms of knee bursitis depend on the phase in which the inflammation is located. The main manifestations include the following:

The manifestation of pain, and if it is acute bursitis of the knee joint, then the pain is sharp, sharp and pronounced.

Both synovitis and knee bursitis cause slight stiffness around the inflamed joint.
over the inflamed joints, redness and swelling are clearly visible, as in the photo.
there is weakness in the muscles,
the patient complains of malaise and a decrease in working capacity,
an increase in local temperature is recorded.

As we have repeatedly said, the problem of diagnosing a prisoner is that bursitis and synovitis have similar symptoms, and at the initial stage they are difficult to differentiate.

Treatment of knee bursitis

Before treating knee bursitis, it is necessary to exclude specific infections that can cause inflammation.

These infections most often include:

brucella,
gonococcus,
Spirochetes.

Naturally, both synovitis and bursitis must be distinguished from arthritis, this is done on the basis of tests.

As for the treatment itself, for example, with acute bursitis at an early stage, the patient should be at rest. A pressure bandage and warm compresses are used for the knee.

In addition, the disease is treated with painkillers and non-steroidal anti-inflammatory drugs.

If there is purulent inflammation with secretions, it will be necessary to take a course of antibiotics, and antibiotics are injected directly into the knee joint, these are intra-articular injections into the knee joint.

The disease involves the use of local therapy to reduce pain. Both synovitis and bursitis can be treated at the initial stages with ointments and creams with a warming, anti-inflammatory and analgesic effect.

Limitation of mobility in the joint requires the use of a complex of physiotherapy exercises. These are special exercises that are developed individually.

Performing a complex of physiotherapy exercises leads to the restoration of the basic functions of the knee. Exercise therapy is used in this case, as an additional treatment for bursitis of the knee joint.

Physiotherapy procedures are also additionally prescribed. As the knee joint recovers, it is recommended to increase the load, and for this you will need to start playing sports and, best of all, swimming.

As for invasive methods of treatment, we can talk about the development of chronic bursitis. It is this development that will require the use of a puncture to remove the accumulated fluid.

After the exudate is drained, it is necessary to rinse the cavity of the bag with a special solution of antibiotics and antiseptics, this should prevent complications and the development of purulent inflammation, as in the photo.

Post-traumatic bursitis involves the use of a hydrocortisone solution, which is injected into the synovial sac.

The prognosis for the treatment of bursitis always depends on several factors, these are:

the degree of change in the tissues of the knee joint,
prevalence of the inflammatory process,
the ability of the inflammatory process to develop further and capture new tissues and areas of the joints,
resistance of the patient's body to the inflammatory process.

Alternative treatment

In the treatment of bursitis, in some cases, non-traditional methods can also be used. However, it is worth immediately clarifying that traditional medicine should act as an additional tool in combination with medications, but not the main one.

A compress of vegetables is often used, and vegetables can be alternated, it can be potatoes, cabbage, beets.

For example, we take a potato, cut it into thin layers before going to bed, put it on a clean material and wrap it around the inflamed joint.

A film and a woolen scarf are applied on top of the joint, such a compress should be on the knee joint all night. Such treatment allows you to remove part of the inflammation and reduce pain.

The next night, you can use the same principle to use a compress of raw beets, then a compress of chopped, fresh cabbage. Treatment continues until the inflammation is relieved.

Another interesting recipe involves the use of a compress with sugar. For this you will need:

heat sugar in a dry frying pan, but so that it does not begin to melt,
then hot sugar is poured into a small bag of dense fabric,
a bag of sugar is applied to the affected joint overnight,
the top is covered with cellophane and wrapped with a warm scarf.

The procedure can be repeated until complete recovery, that is, until inflammation is removed.

In the treatment of bursitis, celery tea helps to cope. This drink leads to the strengthening of the body as a whole, and negatively affects any inflammatory processes.

For cooking, you need 1 tablespoon of celery seeds and a glass of boiling water. Tea is infused for 2 hours, after which you can take it twice a day for 14 days.

Knee bursitis: is surgery necessary?

Our joints are surrounded by bags, which are also called bursa. In shape, they represent a small pocket that is filled with liquid. There are three such bags in the popliteal region. Bursitis of the knee joint is an inflammation of the synovial bags located in the knee area.
Content:

Causes of knee bursitis
Signs of the disease
Diagnosis of the disease
Bursitis treatment

Due to the number of synovial bags, knee bursitis is divided into three types:

Infrapatellar. Most often, such bursitis appears due to tendon injuries. Place of localization popliteal bag.
Baker's brushes. The cause of such bursitis may be excess weight. Usually the inside of the knee becomes inflamed.
Prepatellar. As a rule, it occurs due to injuries of the patella. The site of the lesion is the patella. This species is the most common.

The photo of bursitis shows pronounced thickening.

Causes of knee bursitis

What can cause popliteal bursitis? Popliteal, equally as well as patella, bursitis usually occurs as a result of:

injuries in the knee area;
heavy loads on the knee joints;
infectious diseases that gave a complication to the bursa;
violations of the metabolic process in the body and, as a result, a decrease in the elasticity of the tendons;
autoimmune processes in the body;
anomalies in the development of bones;
body intoxication.

Signs of the disease

The symptoms of this disease are as follows:

Swelling in the knee joint.
Sharp pain on palpation.
Limitation of joint mobility.
Redness of the skin in the affected area.
General malaise of the patient, and in some cases fever.

I must say that bursitis is a disease that any of us is susceptible to. Who thinks about caution and pays attention to minor knee strikes on a hard surface? Meanwhile, attention should be paid, since the consequences in the form of bursitis may not be long in coming.
If the disease still overtook you, how to cure it? Going to the doctor is the very first step on the road to recovery.

Diagnosis of the disease

First, the doctor will conduct an examination. Sometimes bursitis is very well palpable and additional diagnostic studies are not required. In case of uncertainty of the doctor or poorly expressed symptoms during palpation, the following studies are prescribed:

radiography,
ultrasonography,
puncture of the articular bag in order to take the effusion - the fluid that has accumulated.

Bursitis treatment

In the acute form of the disease, surgery is usually not required. Usually, conservative methods are used for treatment. First of all, these are bandages and dressings to lift the joint and limit mobility, since the most important thing for bursitis is rest. Sometimes ice packs can be applied to relieve pain. But it happens differently, it is recommended to use a warming ointment and a heating pad. If the pain is too severe, anti-inflammatory drugs are prescribed, for example, such as novocaine or hydrocortisone.

If there is an infection in the synovial bag, antibiotics are used, for example, levomycin. When the symptoms of acute pain are relieved, UHF therapy and dry heat can be used.

In the case of chronic bursitis, surgery is sometimes necessary. The types of surgery are determined by the doctor. These can be punctures (punctures) in order to remove pus from the synovial bag and treat it with chemical solutions. Repeat this procedure several times. Much less often, the removal of the upper bag is performed, as well as the opening of the bag and its tamponing. The most radical is the operation to remove the bag without opening it.

Alternative Treatments

Treatment at home also gives a good effect. With bursitis, compresses of blue clay and grated potatoes help. Baths with eucalyptus oil or decoction of herbs, such as St. John's wort, thyme, have a beneficial effect on the joints, helping to restore their elasticity. This is a good remedy for sluggish chronic bursitis. You can prepare yourself a very effective infusion for rubbing the affected areas. Such a remedy is also used as a prevention of bursitis and simply if your legs are tired:

You should take (all 100 g each) ammonia and pure medical alcohol, aloe juice and camphor oil, vaseline oil and turpentine. Add two large ampoules of novocaine to this mass, mix and infuse in a dark place for about five days. Before use, warm the mixture, shake and rub the sore spot.
Grind 6 tablets of analgin, a vial of valerian, a vial of iodine, mix a bottle of triple cologne and add analgin in powder to the liquid. Also insist 5-7 days. After rubbing, the legs must be wrapped.

But in addition to medications, there are also gifts of nature that also relieve inflammation and help get rid of bronchitis. When bursitis has been tormenting for a long time, treatment with folk remedies can help you reduce pain.

A bath of coniferous needles is very effective for bursitis. And you can take not only needles, but also cones. They are soaked in cold water and then brought to a boil. Leave in a sealed container so that the broth is infused. Add to bath. For a full bath, you will need about one and a half kilograms of branches, cones and needles. You can simply do baths for the affected areas, then the cost of funds will be less.

Try celery tea. It is insisted for an hour and a half, and then they drink it twice a day. Compresses from propolis infused with vodka will help from swelling of the joints. They should be used until the tumor disappears.

By consulting a doctor in a timely manner, using complex treatment, bursitis can be avoided or completely cured. It's all up to you, because slender legs and a flying gait adorn a person at any age.

Bursitis of the knee joint and its treatment

Our knee joint is easily vulnerable. Quite often, various pathological processes are noted here - injuries, arthritis, arthrosis, bursitis. Treatment of bursitis of the knee joint to a large extent depends on its type, stage and localization.

Causes

Bursitis is an inflammation of the periarticular sac (lat. Bursa - bag). This sac contains synovial or joint fluid. The main functions of this fluid are to reduce pressure on the joint, nourish the intraarticular cartilage. Our knee joint has a complex anatomical structure, because. takes on a significant part of the physical load. And there are 3 joint bags here:

Patellar or prepatellar - located at the top of the knee
Infrapatellar (another name is suprapatellar) - located under the patella, in the area of \u200b\u200bthe tendons of the muscles of the front of the thigh
Goose - located below the inside of the knee.

The main reasons for the development of bursitis:

Prolonged stress on the knee
Skin lesions in the knee area
Open wounds of the knee joint
Sepsis
Overweight
Severe concomitant diseases - rheumatism, gout, psoriasis.

Moreover, each type of bursitis has its own provoking factors. For example, prepatellar bursitis, the most common of knee bursitis, mainly develops with prolonged traumatic loads while kneeling. It happens in certain occupations. No wonder it is called the knee parquet floor, roofer, housewife. Inflammation of goose bags mainly affects overweight women. And infrapatellar bursitis is caused by infections or frequent injuries in certain sports (jumper's knee).

Symptoms

Symptoms of knee bursitis include:

knee deformity
Local swelling of soft tissues
Reddened and hot to the touch skin
Limitation of movements in the knee joint.

The reason for these pathological manifestations is inflammatory changes in the walls of the bursa and the accumulation of pathological fluid in its cavity - exudate. In its composition, the exudate may be identical to the tissue fluid, i.e. serous, as well as purulent with sepsis, hemorrhagic (bloody) with severe injuries.

The severity of manifestations depends on the localization of bursitis. With inflammation of the prepatellar bag, stiffness of movements occurs after a long kneeling. Then, when walking, it decreases. Goose bursitis, on the contrary, manifests itself after a long walk or climbing stairs. Suprapatellar bursitis of the knee joint resolves with severe swelling in the upper part of the knee and severe pain. Often, sepsis leads to this type of bursitis. In these cases, local manifestations go against the background of a general serious condition, a sharp increase in temperature, damage to other organs and systems.

Common Treatment Methods

Treatment of knee bursitis is carried out with medicines, physiotherapy, massage and physiotherapy exercises. It should be noted that the therapy of different forms of this disease has fundamental differences. With infectious wound, traumatic bursitis, antibiotics are required. Moreover, not one, but two or three drugs from this group are prescribed (Lincomycin, Doxycycline, Amoxiclav, Ceftriaxone). Although in some sources the appropriateness of antibiotics is disputed, in this case they are mandatory. Moreover, along with intramuscular and intravenous routes, they are injected directly into the cavity of the bag.

Regarding the puncture (puncture) of the bursa, opinions are also contradictory. According to some statements, the puncture further leads to irreversible structural and motor disorders in the joint. There is a high risk of developing sepsis. But after all, if fluid or pus has accumulated in the joint, they must be removed. Otherwise, any medical treatment loses its meaning, and knee bursitis cannot be cured. In addition, the removal of exudate is carried out not only for therapeutic, but also for diagnostic purposes. Based on the results of microscopic examination or bacterial culture, it is possible to determine the nature of inflammation, determine sensitivity to antibiotics.

In addition to antibiotics, anti-inflammatory drugs are injected into the joint cavity - steroid hormones (Kenalog, Diprospan). And here is the disagreement. The fact is that these drugs to some extent inhibit cell growth, which means that it prevents the regeneration (recovery) of tissues. But the pros (inhibition of inflammation) here convincingly outweigh the cons.

Another popular group is non-steroidal anti-inflammatory drugs. Along with inflammation, they effectively eliminate fever, swelling, and pain. These include Indomethacin, Diclofenac, Voltaren, Ibuprofen. To achieve the effect, they should be used in combination - in tablets, injections, and externally in the form of ointments. True, these drugs negatively affect the functions of the stomach, intestines, and blood coagulation. Therefore, before using these and other drugs, you should always consult with your doctor. Only a specialist knows how to treat knee bursitis with maximum benefit and minimum risk to the patient.

Along with medicines, massage, physiotherapy procedures (electrophoresis, paraffin, magnet), physiotherapy exercises are carried out. All this is carried out already at the recovery stage of knee bursitis. The purpose of these measures is to finally eliminate inflammation, stabilize the knee, and expand the range of motion in this joint.

Treatment with folk remedies

Folk remedies for knee bursitis effectively eliminate pain, swelling. After their use, movements are facilitated, metabolic processes in all tissues of the joint are intensified, incl. and in bursas. However, these remedies are only an addition to the above methods. Contrary to some claims, home remedies alone will not cure bursitis.

And yet, they are effective. Therefore, here are some of the most effective ways to treat bursitis with folk remedies at home:

Baths with extract of coniferous needles. Pine needles, cones and twigs for 30 min. boiled in an enamel pot. Then the resulting broth is still infused for a day. The result is a brownish liquid. In the bathroom, dilute 1-1.5 liters. this liquid. Take a bath for 15 minutes.
In a similar way, you can prepare a decoction of hay dust. The duration of taking baths is 10-15 minutes.
1 st. a spoonful of crushed golden mustache is boiled in 250 ml. water for 5-7 minutes. The container must have a tightly closed lid. The resulting decoction is infused for an hour, and then used in the idea of a compress.
Propolis tincture. To obtain it, within 5 days insist 1 part of propolis in 10 parts of vodka. The resulting tincture is used as a compress.

It should be noted that these funds are contraindicated in case of skin lesions, with purulent bursitis. Therefore, before using them, you should definitely consult a doctor.

The knee joints carry the load of the human body and are often affected by trauma, infectious or systemic diseases. The peculiarity of their structure and functioning leads to the appearance of pathological signs of various localization.

Causes

Pathologies of the musculoskeletal system include damage to the skeleton and soft tissues. Human joints are formed by bones with cartilage on their heads, ligaments, menisci. All these structures are surrounded by sacs filled with synovial fluid.

To understand their condition, patients ask the surgeon: what is bursitis of the knee joint, why does it have various clinical manifestations.

On a note!
Bursitis is an inflammation of the bags located in the knee area with an increase in the production of synovial fluid, the appearance of swelling and pain.

The disease occurs due to various reasons:

knee injury;

intoxication;

infection in the joint;

allergic reactions;

autoimmune disease;

exchange disorders.

Symptoms

The most striking signs of inflammation occur during an acute process. The main symptoms of knee bursitis include:

Constant dull pain, aggravated by resting on a sore leg, bending at the knee.
The appearance of swelling in the joint area. The formation has a rounded shape, dense texture, painful on palpation.
There is swelling of the joint. The range of motion in the knee may be reduced.
The skin over the knee joint in the projection of the swelling turns red, its temperature rises.
Lymph nodes in the popliteal fossa increase, may be painful on palpation.
In some cases, the body temperature rises.

If you carefully consider the photo of knee bursitis, you can notice the above visual manifestations of the disease.

On a note!
Symptoms have different localization. The reason for this is the structural features of the knee joint. It includes 8 bursas with deep or superficial location. Some of them communicate with the capsule, while others look like closed cavities.

So in acute bursitis of the knee joint, inflammation often affects certain bags:

prepatellar bursae not associated with the joint: subcutaneous, subfascial, subtendinous;
deep subpatellar bag (secondarily, as a result of arthritis).

Surgeons have described various localizations of bursitis.

Prepatellar bursitis

This is an inflammation of the prepatellar bursa. It occurs with loads, repeated injuries of the joint, prolonged kneeling.

Rarely develops. The clinical picture includes:

the appearance of swelling;
swelling of the anterior surface of the joint;
moderate pain syndrome;
local fever with reddening of the skin.

Infrapatellar bursitis

This inflammation looks like this: on both sides of the patella, a mobile soft-elastic formation appears, the symptoms are aggravated by pressure, leg extension. Mobility is slightly impaired.

Such bursitis often has a post-traumatic nature.

This inflammation of the joint bag is determined under the tendon of the quadriceps femoris and looks like a large rounded tumor up to 8-9 cm in size. The patient complains of pain in the area of inflammation, unpleasant pulling sensations along the anterior surface of the thigh and decreased mobility in the knee joint.

On a note!
This type of bursitis may be accompanied by fever.

More often it is chronic and leads to deposits of calcium salts (calcareous bursitis).

Popliteal bursitis

The disease is associated with the popliteal bag. Patients turn to the surgeon with complaints of pain on the posterior-outer surface of the joint. Bursitis of the popliteal muscle must be differentiated from damage to the collateral ligament or external meniscus of the knee joint.

On the back surface of the joint, in the popliteal fossa, the so-called Baker's cyst occurs. It is a protrusion of a stretched bag filled with liquid. This disease occurs a second time against the background of synovitis with arthrosis, rheumatoid arthritis, after injuries.

A small cyst is practically invisible and does not cause significant inconvenience to the patient. There are no unpleasant sensations. When a significant volume is reached, it is determined under the knee, closer to the inner surface. To the touch, the cyst has a densely elastic consistency, shaped like an egg. In this case, patients may note:

violation of flexion of the leg in the knee joint;
the presence of a tumor under the knee.

On a note!
These signs occur independently, or against the background of the existing pathology of the joint. Symptoms become more pronounced after a long walk, climbing stairs.

Such chronic knee bursitis can go away without any treatment, when the symptoms disappear when the cyst is emptied into the joint cavity. Sometimes there are complications:

breakthrough education with a clinic resembling deep vein thrombophlebitis;
cyst infection.

The disease occurs infrequently, in persons of mature age. It occurs against the background of arthrosis of the knee joint, overweight.

Disturbs by painful sensations on the inside of the knee. They disturb at night with the pressure of one knee on the other. Palpation of this area is moderately painful, visually one can notice some swelling.

Since the symptom often occurs against the background of gonathrosis, patients report pain in the joint with an increase in the evening.

ICD 10 disease codes refer to M 70:

M70.4 - prepatellar bursitis;
M 70.5 - other bursitis of the knee joint;
M 70.9 - soft tissue diseases due to overload, unspecified.

Development of the disease

If the disease arose as a result of an acute injury, tissue infection is possible, serous inflammation is replaced by purulent inflammation. In this case, the patient will complain of unbearable, “pulling” pains along the anterior surface of the joint, aggravated by palpation, local hyperthermia and redness.

On a note!
Usually acute bursitis lasts up to 2-3 weeks, then the symptoms of inflammation disappear. Recovery is coming.

Accession of the infection is dangerous by the development of purulent arthritis and the formation of phlegmon of the surrounding tissues. With a decrease in immunity and refusal of antibacterial treatment, septic complications are possible.

However, up to 50% of patients are at risk for developing chronic bursitis. Lack of timely treatment worsens the long-term prognosis. In this case, the disease will proceed with episodes of exacerbation and remission. With an exacerbation, the pain syndrome and other local signs are not so pronounced, they have a more “erased” character. Such bursitis is dangerous with gradual changes in the affected joint. There are scars, adhesions, impaired mobility.

With a single traumatic injury, bursitis of the knee joint is acute. Timely treatment leads to recovery, the prognosis for the patient in this case is favorable.

If knee bursitis occurs against the background of chronic injury, joint overload, the symptoms develop gradually with the formation of a protracted inflammatory process. The long course of the disease leads to a gradual deterioration of the condition, it will not be possible to cure it without any consequences.

Bursitis against the background of metabolic or autoimmune disorders develops as a chronic disease with periods of exacerbation and remission. In the absence of adequate treatment, the prognosis for the patient is unfavorable.

Diagnosis of bursitis

He deals with the issues of diagnosis and treatment of bursitis. Upon treatment, the patient will undergo a complete examination:

Interview with clarification of the time of onset of symptoms, connection with stress, injury or other conditions.
Inspection with palpation. The method will help to clarify the localization of pain, assess the change in the configuration of the knee joints, the presence of pain, hyperemia, fever.
Laboratory research methods are necessary for the differential diagnosis of bursitis and arthritis. The doctor will prescribe a general blood test, biochemical and immunological studies, a general urine test.
Instrumental diagnostics is aimed at detecting pathological changes, differential diagnosis with a tumor, hemangioma, arthritis.

Ultrasound or MRI can help determine the location of the joint lesion.

On a note!
X-ray examination is used only for the differential diagnosis of bursitis and arthritis.

With inflammation of the bags of the knee joint in the picture you can find:

change in the size of the joint space due to exudate in the cavity of the bursa;
deposition of calcium salts and osteoporosis in chronic bursitis;
urate masses in place of articular surfaces with gout;
fragments of bone tissue in the joint cavities in tuberculosis lesions.

What and how to treat

There are the main methods of treating inflammation of the bag:

compliance with the protective regime;
the use of medications;
physiotherapy;
traditional medicine;
surgical treatment
lifestyle change.

Mode for bursitis

To alleviate the condition of a patient with acute bursitis or at the stage of exacerbation of a chronic process, the following rules are recommended:

Ensuring rest of the knee joint. The patient needs bed rest, the limb should be kept elevated.
Joint unloading. Recommend the use of elastic bandages, canes.
Cold on the knee. This measure in the first few days from the onset of inflammation will help relieve pain and swelling.

On a note!
Patients often ask about the diet for bursitis. There is no special diet. However, you should pay attention to the diet and limit its calorie content in the presence of excess weight, monitor the sufficient intake of proteins, vitamins and vegetable fiber.

Medical treatment

Taking medications for inflammation in the joint is aimed at stopping pain and reducing inflammation. In acute bursitis, drugs are used in courses; chronic process requires supportive treatment for autoimmune or metabolic disorders. Surgeons prescribe the following groups of drugs:

Non-steroidal anti-inflammatory drugs in the form of tablets and (Nimesulide, Meloxicam, Aspirin, Ibuprofen). Local treatment of bursitis of the knee joint with NSAIDs is possible only while maintaining the integrity of the skin.
Hormonal preparations in the cavity of the bursa with severe inflammation (Hydrocortisone, Kenalog, Diprospan).
Broad-spectrum antibiotics in the development of an infectious process. Surgeons recommend treatment with drugs of a number of penicillins, cephalosporins.

Compresses with dimexide are recommended in the absence of wound surfaces. They are prescribed for both acute and chronic inflammation. To enhance the effect, mixing the main substance with novocaine and corticosteroid hormone is recommended. The duration of the procedure should not exceed 30-40 minutes, the course of treatment - up to 10 days.

exercise therapy and physiotherapy

Hardware treatment of bursitis is used in inpatient and outpatient settings. The scheme of procedures is selected by a specialist, taking into account possible contraindications to the procedure. The following methods have been proven effective:

shock wave therapy;
electrophoresis with drugs;
UHF therapy;
magnetotherapy.

On a note!
The use of physiotherapy exercises is recommended for patients after injuries and with chronic bursitis. Perform exercises through pain in an acute process should not be. Patients are advised to exercise on an exercise bike, swimming, active and passive flexion of the legs in the knee joints.

Treatment with folk remedies

To combat bursitis, methods of local and general exposure are used. Before starting treatment, the patient should consult with the surgeon.

Locally, for acute pain, ice, cabbage compresses, aloe are prescribed. To alleviate the residual symptoms of the disease, baths with needles, hay, hot lotions with herbs are used. The course of such treatment can take up to 1-2 weeks.

For oral administration, followers of traditional medicine recommend infusions and decoctions of herbs that have an anti-inflammatory, cleansing effect: clover, chamomile, St. John's wort, horsetail, linden.

Surgery

bursa infection;
ineffectiveness of conservative therapy;
development of chronic bursitis.

Surgical treatment for purulent bursitis consists of puncture of the cavity, washing and administration of antibacterial agents. In case of severe inflammation, the surgeon will drain the knee bursitis: opening the bag and introducing a special drainage into it, through which the inflammatory exudate will drain.

In case of chronic inflammation and the ineffectiveness of conservative treatment methods, bursectomy of the knee joint is recommended. Before surgery, the doctor evaluates the patient's condition - the duration of the disease, the degree of mobility impairment, the severity of the pain syndrome, the number of intra-articular hormone injections performed.

The operation is performed in two ways: open and endoscopic.

In an open bursectomy, the surgeon opens the bursa, cuts it open, and sutures it. During endoscopic surgery, manipulations are carried out through punctures; this method speeds up the recovery of the patient. The effectiveness of the surgical method is high.

For 4 years, I "grew" a tumor the size of a good egg under my knee. At first I did not notice the presence of this formation, then I hit my foot at a construction site and the next day I could not bend my knee. There was pain and some kind of round bump. Without attaching importance to this, I did not take any treatment and did not go to the doctor for another couple of weeks, until my frightened wife took me by the hand and took me to the surgeon.
I went through an examination and found a cyst. It hurt to bend my leg. The traumatologist warned that it would not go away on its own, only surgical treatment was needed. Having studied the reviews about the operation of other patients, he agreed to arthroscopic removal. It cost me a lot, but after 3 days I was already on my feet. Six months have passed since the treatment. There are no complaints.
Nikolai, Moscow

The human knee joint performs a serious function - it helps a person to move, to make fast and dynamic movements. If discomfort appears in the knee area, a person cannot walk normally, he begins to limp and suffer from discomfort.

A symptom such as pain in the knee joint can be a sign of a serious pathology, such as knee bursitis. It usually leads to a serious impairment of motor activity, so it is important to know the symptoms of the disease and how to treat knee bursitis correctly. Timely and competent therapy will help get rid of pain and reduce the risk of serious complications.

Bursitis is an inflammation of the joint space formed by the synovial membrane, which contains joint fluid, it is called the synovial bag or bursa. The joint bag with fluid plays an important role in the work of the entire joint, thanks to this structure, its normal mobility is ensured, and the joint fluid lubricates the cartilage, preventing them from fraying.

With inflammation of the bursa, serious disorders occur, the joint ceases to be lubricated normally, since the synthesis of synovial fluid is disrupted. As a result of such disorders, the cartilage begins to slowly fray, the joint ceases to move normally, and the damaged areas are overgrown with bone tissue. This whole process is accompanied by very painful sensations.

The development of the disease takes place in several stages:

At the first stage, bursitis is called acute, it occurs for the first time and is very painful, with swelling and impaired activity.
In the second stage, the signs of the disease subside and the pain becomes dull;
In the third stage, bursitis becomes chronic, because despite the absence of pain, the joint continues to collapse due to a lack of joint fluid. In this case, the motor activity of the knee is disturbed, relapses may occur regularly, accompanied by symptoms of acute bursitis.

Causes

Bursitis usually does not appear without a reason, sometimes it is provoked by various infections, but most often the disease occurs after mechanical damage to the joint and its surrounding tissues. The following situations can trigger knee bursitis:

Bacterial infection. Infection can occur through a wound or pass through blood from other parts of the body, more often in advanced cases.
Injuries and physical activity. Too active training can provoke the inflammatory process of the bursa, in which most of the load falls on the knee joints. Also, the disease often occurs after bruises, sprains, for example, during a fall or a sharp and awkward movement.
Autoimmune diseases and metabolic disorders, in this case, salts can be deposited in the joint, provoking an inflammatory process.
Endocrine disorders, hormonal disruptions.
Hypothermia. In this case, the inflammation is non-infectious;
Arthritis, arthrosis;
If a person kneels for a long time, for example, at work, inflammation in the knee joint may also occur.

It is important to note that sometimes it is not possible to establish the exact cause of the disease, it is possible that many negative factors have an influence at once, for example, an unhealthy lifestyle, working on your feet. After all, the joints can become inflamed if you do not follow the diet and the mode of work and rest, so they can suffer with increased stress and vice versa, with a passive lifestyle.

Kinds

There are three synovial bursae in the area of the knee joint, and each of them can become inflamed. Depending on the location of the infection, bursitis is divided into three main types:

Also, bursitis of the knee joint is divided into acute and chronic, and in the presence and absence of infection into purulent and serous, respectively.

Symptoms

As a rule, knee bursitis is always accompanied by pain, especially during movement and impaired motor activity, in this case, a slight swelling and induration may appear in the area of the bursa. Depending on the type of bursitis, other characteristic symptoms may occur:

It is worth noting that in the acute form, the symptoms are usually pronounced, but if the disease has become chronic, the pain disappears and may not bother the patient at all, or occur after heavy exertion. But in this case, exacerbations always occur, which give out the disease.

Diagnostics

Only a competent specialist can identify the symptoms of knee joint bursitis and prescribe treatment, since there are many joint pathologies that are accompanied by pain, swelling, and even fever. Therefore, it is very difficult to make a diagnosis on your own, especially without knowledge in the relevant field and test results.

Bursitis is treated by orthopedists, traumatologists and surgeons, but first of all, the patient will probably have to visit a therapist and tell him about his complaints. The general practitioner should issue a referral to the right specialist. At the first examination, the specialist interviews the patient, it is important to remember what chronic diseases the patient suffers from, whether there have been recent injuries and infectious diseases.

Also, the doctor will conduct an external examination and palpation. Based on the data obtained, the specialist will certainly be able to establish a preliminary diagnosis, to confirm which he will send a series of studies. The exact list of tests can only be announced by the attending physician, but most often they are sent to the following studies:

Puncture of joint fluid;
radiography;
Urine and blood tests.

Based on the tests and the patient's history, the doctor makes an accurate diagnosis and prescribes the necessary treatment. Bursitis can be completely cured only under the supervision of a specialist, otherwise it will become chronic and cause a lot of inconvenience. Therefore, at the first sign of illness, you should consult a doctor.

Treatment

The method of treatment depends primarily on the type of bursitis, since in each case different drugs are needed. But for any type of inflammation, non-steroidal anti-inflammatory drugs are prescribed to relieve pain, in addition, they relieve fever and reduce the inflammatory process in the bursa. In addition, in the acute phase of the disease, complete rest of the limb is indicated to reduce the risk of joint destruction.

Infectious bursitis of the knee joint is treated with antibacterial drugs, while a therapeutic puncture of the synovial bag is indicated, in which the doctor removes pus and flushes the bursa cavity with an antiseptic. A drainage of the articular sac can also be installed to drain pus. In advanced cases, surgical removal of the bursa is indicated.

With serous (non-infectious) bursitis, anti-inflammatory drugs are indicated, as well as visits to physiotherapy. For severe pain, the doctor may inject corticosteroids, these are hormonal drugs that quickly relieve inflammation and pain. And with excessive secretion of synovial fluid, especially with a Baker's cyst, drug puncture is indicated.

How is a drug puncture performed:

At the first stage, the doctor treats the skin with an antiseptic and injects a local anesthetic;
Then a large syringe with a long needle is taken, which is inserted into the cavity of the bursa, the doctor pumps out the synovial fluid or pus, takes a part for analysis if necessary;
Next, the doctor washes the cavity of the bursa with an antiseptic, may administer medications, depending on the type of bursitis.

The puncture is completely painless and does not cause any complications, it helps to quickly get rid of the inflammatory process and alleviate the patient's condition.

For any type of bursitis, drugs for external use are prescribed, most often these are ointments with a non-steroidal anti-inflammatory agent. Also, the doctor may prescribe a homeopathic ointment or herbal medicine in complex treatment to alleviate the patient's condition.

Therapeutic treatment for any type of bursitis is to use physiotherapy methods. It is important to note that with purulent bursitis, in no case should you warm up the sore spot, this will lead to a worsening of the condition. That is why it is better to resort to such methods of treatment only on the recommendation of a doctor.

Bursitis of the knee joint is treated with the following procedures:

Radiation therapy;
Warming up with paraffin;
Therapeutic exercise after removing inflammation and other symptoms.

Folk remedies

Treatment of bursitis of the knee joint at home is possible only after consulting a doctor. Experts do not approve of the treatment of bursitis exclusively by folk methods, as this can be very dangerous, because no lotions will rid the body of the infection, if it is present.

In addition, the anti-inflammatory effect of folk remedies is very weak, the disease can quickly become chronic, and the patient will not even notice it, and will most likely think that the pain has gone thanks to folk recipes. In this case, bursitis will soon make itself felt, but in the form of an exacerbation of the chronic form.

To avoid constant pain and relapses, you should immediately consult a doctor and be treated normally, going through all the prescribed procedures and taking medications. Competent therapy will help to get rid of the problem forever and never remember it again.

Prevention and prognosis

Bursitis is a very serious and dangerous condition if left untreated. If inflammation provoked an infection, suppuration will soon appear, the infection will spread to the bones and osteomyelitis will occur, if bacteria and pus enter the bloodstream, sepsis is possible. These complications are very dangerous for human life and often provoke a fatal outcome.

If bursitis is non-infectious, it is complicated by the fact that it becomes chronic. In this case, a person is initially disturbed by periodic pains, which gradually become permanent. Quite often, the disease worsens, swelling of the knee appears and it becomes impossible to step on the leg due to pain.

In the chronic form of the disease, adhesions and scars form in the bursa, due to which the joint suffers from a lack of synovial fluid and collapses. As a result, arthritis occurs, the joint loses its motor activity and the person becomes disabled.

With timely diagnosis and proper treatment, you can permanently get rid of bursitis. But in the future, it is necessary to observe preventive measures in order to avoid the occurrence of the inflammatory process again:

It is necessary to take care of the knees, especially the one that has suffered bursitis. It is not necessary to actively load the knee joints, it is not recommended to be on your feet for a long time without rest.
It is impossible to supercool and supercool the knee joints in particular;
It is recommended to treat all infectious diseases in time under the supervision of a doctor, be sure to consult a doctor in case of injuries to the diseased joint;
It is imperative to lead a healthy lifestyle, that is, eat right and do exercises.

In every major joint of the human body there is a periarticular bag - a bursa filled with fluid, the main purpose of which is to reduce friction and stress on the tissues of the joint.

Bursitis is an inflammatory process of the cavity that occurs due to injury or infection. There are three periarticular bags in the knee.

The attending physician, when deciding how to treat knee bursitis, will determine the location and severity of the inflammation. According to the results of the study, the disease is assigned an ICD code.

Bursitis of the knee joint - what is it, causes and symptoms

Near the knee joint there are three bursae filled with fluid. Inflammation of the periarticular bag can provoke several main reasons:

The symptomatology of the disease is pronounced and depends on the location and intensity of inflammation. It is customary to distinguish the following symptoms of bursitis:

Pain.
Changing the shape of the knee.
Edema.
Change in color and temperature of soft tissues.
Mobility restrictions.

The consequences of bursitis of the knee joint can be a permanent limitation of mobility, sepsis. At an advanced stage, surgery will be required to remove the joint bag.

Varieties of knee bursitis

It is customary to distinguish three main types of bursitis, depending on the location of the inflammation. Namely:

Goose bursitis.
Prepatellar.
Infrapatellar.

In humans, there are three periarticular bags in the knee. Depending on where exactly the inflammatory process began, one or another form of bursitis is diagnosed. In addition to this basic classification, in medical articles you can find the following terms related to one form or another of the disease:

Ossifying bursitis - characterized by the presence of seals in the knee area. As a result of the disease in this form, the patient has significant limitations in mobility.
Anserine bursitis - most often develops in women who are overweight. The internal cavity of the joint, called the "crow's foot", becomes inflamed at the junction of the semitendinous, tailor and graceful muscle tissue.
Acute bursitis is characterized by intense pain localized at the site of inflammation of one of the bursae. The inflammation proceeds quickly. A large amount of serous exudate is released.
Chronic bursitis - occurs in people whose professional activities are associated with permanent injuries or stress on the knee. The synovial bag grows slowly, exudate collects in it, the bursa membrane changes. Growths and cysts appear.

Surgery for bursitis is rarely required and is prescribed as a last resort when traditional drug therapy has failed. During surgery, the inflamed joint capsule is removed, which leads to the patient's disability.

What is dangerous bursitis in the knee

The danger is no longer associated with the disease itself, but with the complications to which it leads. Prepatellar, suprapatellar and other types of bursitis are characterized by increased release of exudate. The composition of the substance may be different. The greatest concern is purulent discharge. If timely measures are not taken, the disease can be fatal.

Another unpleasant consequence of the inflammatory process is the removal of knee bursitis. This measure is resorted to only in extreme cases, as it leads to a permanent limitation of joint mobility.

The consequences of knee bursitis depend on the location of the inflammatory process, the nature of the manifestation and the causes that provoked the onset of the disease. So infrapatellar bursitis of the knee joint, in general, responds well to drug therapy, and infectious is often associated with the need for long-term antibiotics.

How to treat bursitis in the knee (traditional methods)

Drug treatment of knee bursitis includes taking painkillers and anti-inflammatory drugs. In the presence of purulent discharge, a course of antibiotics is prescribed, which are injected directly into the cavity of the articular bag.

Drugs for treatment are prescribed exclusively by the attending physician, according to the results of a diagnostic study of exudate sampling. The intensity of drug intake is selected based on the general condition of the patient. To reduce pain, relieve inflammation and treat the knee joint with bursitis, ointments are prescribed.

With limited mobility with bursitis of the knee joint, a set of exercise therapy exercises is prescribed. Classes are developed individually and contribute to the restoration of the basic functions of the knee.

The patient is additionally assigned a visit to physiotherapy. As you recover, it is recommended to gradually increase the load, play sports, visit the pool.

Self-medication for treatment is strictly contraindicated. In case of recurrence of the disease, before prescribing therapy, it is necessary to retake all the necessary tests.

Alternative methods for knee bursitis

Effective treatment of bursitis of the knee joint with folk remedies is associated with measures that help strengthen the immune system and restore the normalization of the body's metabolic processes. A good effect is the intake of apple cider vinegar, crushed leaves of a golden mustache.

You can remove puffiness with a compress of burdock leaves. A decoction of the crushed roots of the plant helps. A spoonful of the crushed mixture is poured into 0.5 liters. water. Boil for 5 minutes. Apply a compress for 2 hours.

You can reduce the unpleasant symptoms of suprapatellar bursitis of the knee joint with the help of propolis tincture on vodka. The mixture is prepared in a ratio of 1 to 10. Infuse for 5 days.

Treatment of knee bursitis at home does not eliminate the need to consult an orthopedist. Some types of inflammation can only be removed with the help of drug therapy.

Restoration of the knee joint after bursitis

The speed of restoration of knee mobility is largely related to the efforts of the patient himself. To shorten the rehabilitation period, it is necessary to perform physical exercises, play sports.

It is necessary to abandon activities that lead to the formation of microtraumas of the joint. At this stage, folk remedies are effective: infusions and compresses that reduce swelling.

To date, there is no worthy alternative to traditional methods of treatment. Folk methods can only be used as an aid to the rapid recovery of the patient.

Each joint experiences stress in the form of friction of the tendons, ligaments and muscles related to it. Therefore, in the process of evolution, special slit-like bags appeared in humans, located near the place of attachment of these ligaments. When an infectious agent enters, there is bursitis - inflammation of the bursa. The article will discuss the mechanism of development of knee joint bursitis, its symptoms and treatment.

In the area where the bursa is located, the tissues surrounding the knee joint move with the greatest amplitude. From the inside, the bursae are lined with a synovial membrane. In total, there are 8 bursae in the region of the knee joint. Near the joint there are 4 bursae - in the upper part of the knee, lower, above the patella, behind the joint. The anatomical name is suprapatellar, infrapatellar and prepatellar bursa.

What is bursitis

Bursitis of the knee joint is called an infectious inflammatory process, localized in the prepatellar bag. They are located:

under the skin (subcutaneous bursa);
under the tendon (subtendon);
under the fascia (subfascial).

Code according to ICD 10 (International Classification of Diseases 10th revision), bursitis of the knee joint is placed in the chapter M70.4- prepatellar bursitis, M 70.5- bursitis of another bag.

Causes of bursitis

There are several factors that can trigger the development of bursitis.

post-traumatic occurs after fractures, dislocations, ruptures of the connective tissue. This category also includes bursitis, which has developed due to frequent stress on the knees. For example, athletes, builders, employees of law enforcement agencies. This type of bursitis is the most favorable in the prognosis.
Infectious- penetration into the bag of pathogenic microbes, such as staphylococcus, leads to suppuration of the bursa. Treatment of such a focus of inflammation should be started as early as possible, in order to avoid serious consequences, such as blood poisoning, leg amputation.
Secondary occurs due to concomitant diseases: arthritis and arthrosis, endocrine disorders, etc. Such bursitis often becomes chronic.

The symptoms of bursitis depend on the severity of the inflammation and the location of the bursa.

Bursitis classification

According to the anatomical location of the inflamed bag, bursitis is divided into:

Prepatellar when the bag located in front of the patella is inflamed. This is the most common type of bursitis. The main etiological factor is trauma.
suprapetellar. The bursa in the upper part of the patella is affected.
Infrapatellar. The bursa in the lower part of the patella is affected. Occurs as a result of falling on the knee.

Clinical classification distinguishes the degree of pathological changes in the bursa:

Acute when severe inflammation of the bursa, sharp pain in the leg. Lasts approximately 30 days.
subacute, during which the swelling of the knee decreases, the pain is not so strong.
Chronic, in which the disease flows slowly, development can stretch for a year.
recurrent, is characterized by sudden exacerbations due to adverse environmental factors.

The most dangerous outcomes of bursitis are osteomyelitis(bone suppuration), as well as sepsis- Infection with toxins of the blood and other organs.

Symptoms

There are several symptoms of knee bursitis:

severe inflammation and pain of the knee joint, especially when you press it with your hand;
increase in body temperature;
the manifestation of frequent pain at night;
development of weakness in the muscles, difficulty walking;
swelling of the knee compared to a healthy one by 8-10 centimeters;
redness of the skin above the knee;
difficulty in movement in the joint, which also begins to hurt;
weakness, fatigue, malaise.

If you have at least one or two symptoms, you should consult a surgeon to clarify the diagnosis and begin adequate treatment.

Diagnostics

First of all, a general examination and questioning of the patient is carried out. To clarify the diagnosis, you need to perform additional diagnostic procedures, for example:

collection of anamnesis;
radiograph of the knee joint;
sampling and analysis of fluid in the joint by puncture;
general and biochemical analysis of blood and urine;
research using a thermal imager.

The more different examinations there are, the more accurately it will be possible to differentiate bursitis from other diseases with similar symptoms, such as osteomyelitis, arthrosis, knee ligament rupture, etc.

How to treat knee bursitis? In the initial stages of bursitis, doctors offer drug treatment. However, if the stage of suppuration has begun, sharp pains, due to which a person cannot even sleep, then they resort to surgical intervention. It is important not to give it up, because. it is impossible to cure festering bursitis with medicines.

In addition to taking drugs, you need to follow some rules:

ensure rest of the limb with bursitis, limit movement in the joint;
in severe cases, observe full bed rest;
do not wrap your knees with bandages;
do not use any cold and hot procedures (compresses, heating, baths, etc.) in the knee area;
use crutches when walking.

Medical treatment

Pharmacotherapy is carried out in three areas:

cessation of the inflammation process;
restoration of metabolism in the joint and tissues around it;
the rehabilitation period after the subsidence of the main symptoms.

In the fight against inflammation, both local and general preparations are used. The first are applied in the form of ointments and gels. These include:

Diclofenac;
Long;
Fastum gel.

These and other drugs are applied to the diseased joint twice a day. First, they are gently rubbed until dry, then a gauze compress with Dimexide solution is applied for several hours. These funds belong to NSAIDs (non-steroidal anti-inflammatory drugs). They have common contraindications for all:

individual intolerance and allergy;
ulcers of the stomach and duodenum;
allergic reactions;
aspirin bronchial asthma.

In some cases, the doctor may perform topical therapy corticosteroid injections. The latter are divided into high-speed (Celeston, Hydrocortisone) and long-acting (Diprospan). These drugs are well tolerated, have no side effects, and can lead to results such as:

restoration of joint functions;
preventing the transition of bursitis into a chronic form;
reduce inflammation in a short time.

The procedure should be carried out only by a doctor. An anesthetic is used to prevent pain during the injection. The number of injections of corticosteroids is determined individually, usually from 5 to 10.

Physiotherapy

After the extinction of the main process of inflammation, trophic physiotherapy has a good effect. This method includes the following procedures:

ozokeritotherapy;
laser treatment;
electrophoresis with Dimexide and other medicinal substances;
magnetotherapy;
paraffin therapy;
treatment with drugs with aloe, fibs, solcoseryl;
the use of B vitamins, antioxidants, nicotinic acid.

During the rehabilitation period, physiotherapy exercises, treatment at balneological resorts, and massage are used.

Surgical treatment

Surgical intervention is performed with the ineffectiveness of conservative methods, with advanced cases of knee bursitis. The main method is aspiration.

Using a special thin needle, the doctor sucks out the pus, and then injects antibiotics, corticosteroids. After such an intervention, you need to wear an elastic bandage for 48 hours.

Depending on the symptoms of knee bursitis, treatment may be more radical. If aspiration did not help, they begin to remove the bag of the joint, in which suppuration has developed. A couple of days after that, you can already make movements of the joint, but limited. Full recovery of all functions and discharge home is made 2-3 weeks after the operation.

ethnoscience

Remedies from the arsenal of traditional medicine will help cure bursitis. Possible methods of such treatment are listed below (only in addition to drug therapy!):

Alternately do compresses with potatoes, cabbage and beets. To do this, you need to cut them in the form of circles and place on the fabric and attach to the sore knee. Wrap a warm cloth and cellophane on top and leave it overnight. Make compresses until complete recovery.
tablespoon celery seeds pour 250 ml of boiling water, leave for two hours. Strain, drink morning and evening for two weeks.
Do compress from a hammered cabbage leaf within 7 days.
Do compresses from a decoction of burdock root. To do this, take 15 grams of raw materials, boil for 5 minutes. Apply such a compress to the knee for two hours for 20 days.
Put in a cotton bag flax seeds apply it on the knee for 2 weeks.
500 ml of boiling water pour 1 tbsp. spoon salt. Soak a woolen scarf there, then attach it to the knee for a period of 3 to 8 hours, wrapping everything in cellophane. Carry out the procedure once a day for a week.
10 grams propolis pour 150 ml of vodka, leave for 5 days. Apply in the form of cotton pads to the swollen joint until complete recovery.
Apply at night bag with sugar heated in a frying pan. Treat in this way until the swelling subsides.

There are contraindications, it is necessary to consult a specialist.

Rehabilitation

During this period, you need to avoid any injuries to the knee joint, do small physical exercises to develop the knee, apply infusions and compresses. It must not be forgotten that traditional medicine is only an additional method of treating bursitis, and not the main one.

Prevention

Prevention and prevention of the disease consists in the following activities:

body weight control;
protection of the joint area from injuries at high risks of damaging it;
before doing exercises, do a warm-up;
avoid exposure to low temperatures;
do not engage in heavy physical activity;
treat all infections in time;
strengthen the ligaments of the joints with the help of exercise and physical activity.

Conclusion

Like any disease, bursitis is easier to cure in the initial stages than to get rid of its consequences, which seriously impair the function of the knee joint (abscess, fistula, osteomyelitis, etc.). For this reason, with any symptoms, you should not delay contacting a doctor.