Bursitis of the knee joint. The symptoms and treatment of folk remedies, medicines. What is prepatellyarny, suprapatellyarny, infrapatellar, anzerinovy ​​than dangerous. Photo

Bursitis of the knee - a dangerous disease characterized by specific symptoms and complications. It is important to know in good time about the causes, symptoms and treatments of this disease.

What it is?

Around the knee joint are bursae (bursitis) - additional protection - which differ in location.

Several of them:

• supergenual (Compound occupies the region of knee cartilage, top) - suprapatellyarnaya;
• predkolennaya (Located immediately behind the cup) - prepatellyarnaya;
• popliteal (At the bottom of the kneecap tendon) - infrapatellar;
• anzerinovaya (Inside closer to the rear) - the crow's feet.

Inside bursa covered with synovial tissue rich in fibers, which emit exudate. It is a clear, yellow, kiselepodobnaya consistency, collecting in bags and to serve as a protective cushion. Due to injury or other adverse external or internal influences "cushion" inflamed, causing a disease called bursitis.

Outwardly, it appears redness, swelling of varying intensity. Movement thus limited, an increased pain. The site of inflammation is hot.

How dangerous

Bursitis is dangerous by itself, and possible complications. For example, when a strong impact synovial bags (bursa) take the brunt, protecting the joint. As a result, a strong burst injury vessels, the blood is mixed with the synovial fluid decomposes and becomes inflamed.

After contact with possible infections suppurative inflammation that can infect nearby lying areas, to cause abscesses, phlegmon, fistulas, up to necrosis. With rapid course of disease assume fatal.

Increased inflammation of the bursa compress surrounding tissue and adjacent intercellular spaces. These disorders interfere with the free movement of the joint and cause lymphadenitis.

Possible accumulation of salts - calcification. In this case, strong brakes and broken joint function.

The above and many other complications are accompanied by severe pain, functional impairment, lymphadenopathy, intoxication, irreversible consequences, leading to disability.

Causes

Bursitis of the knee (the symptoms and treatment will be specified below) is called a variety of reasons. The main ones are hard knocks and injuries that occur in industries during traffic accidents.

One can not ignore the overload experienced by athletes, especially weightlifters. However, overload occur, and in some kinds of athletics (eg, high jump), their experience and the players, and people involved in winter sports.

Inflammation appears as a complication of a variety of infections (flu, SARS, tuberculosis, childhood diseases), due to allergies, poisoning, errors in metabolism, excess weight.

Great danger are systemic connective tissue disease:

• rheumatoid arthritis;
• multiple sclerosis;
• scleroderma;
• lupus erythematosus.

Popliteal bursa can be affected by:

• diffuse toxic goiter;
  
• Addison's disease;
• type 1 diabetes.

Various autoimmune diseases have in the first place, the impact on periarticular bag.

Types and forms

The disease occurs in acute and chronic forms. Undertreated or bursitis caused sluggish flowing prolonged systemic disease patient on chronic doom during which constantly kept under control and prescribe appropriate treatment, achieving lengthening remission.

The disease is classified according to the nature of the synovial fluid:

• serous;
• purulent;
• infectious;
• lime.

The main varieties can be seen in the table below:

Title	Deep or Surface	location	Cause
Prepatellyarny	surface	Between the folds of the skin and the tibia, supergenual	A direct hit, long doggy style
Suprapatellyarny	surface	Patellar upper part of the knee	Strong loading and front knee injury
infrapatellar	deep	Popliteal tendon area	Severe damage to the popliteal region (jumper's knee, parachutist)
Anzerinovy ​​or goose foot	deep	The inner part of the knee, to the rear of the approximate	Strong compression of the bone together with overweight

In acute inflammation of the integrity of the walls is broken, exudate misses the popliteal fossa determined hernia, so-called Baker cyst. Often diagnosed inflammation of not one but two or more bags.

Signs and symptoms of type

Bursitis of the knee (the symptoms and treatment of which will depend on the type of bursitis, which protect the joint and are located in an area okolokolennoy) prepatellyarny suprapatellyarny and characterized by severe pain, erythema bright, swelling. Knee hot, palpable pulse. Highlighted the chronic form, when the symptoms are less pronounced.

External signs at infrapatellar bursitis less pronounced or not at all, but there is considerable pain. additional methods are involved to establish the diagnosis.

Anzerinovy ​​(goose) bursitis manifested by severe pain, enhanced by gradients.

The accumulation of serous fluid and edema expressed little pain. When timely treatment favorable outcome. If the process involves the infection, there are signs of intoxication, fever. Calcific (lime) form differs particularly obtrusive pain impeding free movement.

methods of diagnosis

Many diseases, such as arthritis, injuries have the same symptoms. It is difficult to differentiate bursitis with fibroids, lipomas, hemangiomas.

Modern methods of diagnosis:

• contrast radiography;
• endoscopy;
• angiography of blood vessels;
• Ultrasonography (ultrasound);
• CT scan;
• Magnetic resonance imaging.

Endoscopy or arthroscopy - the most accurate examination. On the surface of the knee it makes a small incision through which introduced a special probe - an arthroscope. During the procedure make it even puncture through which the cavity is constantly washed with sterile saline. All survey data is displayed on the monitor screen.

Arthroscopy may be used for micro-operations, e.g., to remove the deposited salt or purulent exudate extraction followed by administration of the antibiotic.

Angiography is typically conducted in parallel with the magnetic resonance imaging. After introduction of a special contrast agent into the vessels of the knee region of its exposed frequency radio pulses using magnetic fields. The processed information about vascular status is transmitted to the computer monitor.

If you suspect of being infected bursae pathogens prescribed puncture for bacteriological examination of synovial fluid. Decisive in diagnosis is a careful examination of the patient's specialist, carefully collected history and determine the level of motor function.

surgical method

Negative results when examining threatening complications, futile treatment, - favor the most radical method - bursectomy.

The operation is performed at:

• suppuration;
• protracted course of the disease can not be cured;
• tissue necrosis;
• penetrating injuries;
• calcification.

There are a number of contraindications:

• nesvorachivaemost blood;
• diabetes;
• arterial hypertension;
• infection;
• worsening of existing chronic diseases;
• untreated severe bursitis.

Before the surgery, the patient must undergo a standard examination:

• general analysis of blood, urine;
• analysis of blood clotting, hemoglobin;
• blood type;
• X-rays;
• Ultrasonography (ultrasound);
• determination of the degree of joint movement (inclinometer);
• Other studies have indicated.

In preparation for surgery include:

• refusal to eat for 6-8 hours before the start;
• rejection of the use of a liquid for 1.5-2 hours;
• showering;
• elimination of hair at the site where the surgery will take place.

The procedure is performed under local anesthesia or spinal cord.

Step by step move:

1. It is a longitudinal sectional view.
   
2. Released access to the seminary.
3. Excision of tissue held a special clip.
4. Insert the drain.
5. Sutured.
6. Put a pressure bandage.

rehabilitation after surgery

Proper postoperative care is much more important than the operation itself. The first 3-4 days adhere to gentle treatment. In the early hours of prescribed cold, elevated position (enclose roller), pain relievers, antibiotics if indicated. Bursitis of the knee (the symptoms and treatment is discussed in detail) requires a special rehabilitation program.

It includes:

• healing procedures;
• physiotherapy;
• gymnastic exercises;
• training on simulators;
• massage, diet.

The apparatus of one of the simplest simulators consists of a metal frame. The leg is attached to the pedal. On the lower part of the thigh cuff is worn, to which blown air. Gradually expanding, cuff pad presses on the foot down, forcing the knee to go down lower and lower, gradually straighten it.

Any exercise will cause pain. To successfully restore function, everyone needs to go through this pain. With each passing day it will become less and less and gradually come to naught.

Some gymnastic exercises, which are advised to carry out already in the third day:

1. Under ankle sore feet enclose a small rise (folded towel). Trying to press on the towel at score 1, 2, 3; 4 relax the leg.
2. In the supine position reduce the gluteal muscles. On account of 5 relax.
3. Lying try to pull the socks themselves. Once or twice. Repeat this exercise every day, try to increase the range of motion. Exercise complicate adding sliding on a sheet heels into the sides and back.
4. Roller under the knee. Tear off a leg, aligning it on the roller.

Gradually increase the time occupation.

medication

For the treatment use vast arsenal ointments, tablets, solutions. Selected antibiotics, hormone drugs, which are taken not only inside, but also injected directly into the affected area.

This is clearly shown in the following table:

Title	Act	Features, contraindications
groups: macrolides cephalosporins penicillins	antibiotics antibacterial	Verified by their action on pathogens contained in the puncture specimens
Procaine, solution 0,5 – 0,25%	Tablets, solutions Analgesic, for blockades	After checking the increased sensitivity of the organism. Children up to 12 years, hypotension, ulcers
hormonal: methylprednisolone diprospan hydrocortisone Triamtsinalon	When pain if not acting analgesics	Under the supervision of a physician
Muscle relaxants: diazepam baclofen	Reduction of muscle spasms
analgesics: analgene Pentalgin Panadol Nurofen	relieves pain	After the elimination of pain reception is not suitable
anti-inflammatory: Preparations of Diclofenac: Revmoksikam ibuprofen ketoprofen	Coping with pain, inflammation, reduce edema
Voltaren	ointments Relieves pain and inflammation	analogue Diclofenac
Deep Relief	Strong analgesic effect, cools	The basis of menthol, Ibuprofen
ortofen	decongestant	Diclofenac enters
Finalgon	Warming	After removal of inflammation
Viprosal Apizatron	Warming, anti-inflammatory	The basis of bee and snake venom
Kamfotsin	Warms, relieves inflammation, increases blood flow	Pepper contains. Can not be applied to broken skin, there is increased sensitivity
Dimexidum p-p; Bile (bovine, medical)	for compresses	In cardiovascular diseases, diseases of the kidney, liver, angina during pregnancy.

Physiotherapy

Of physiotherapy interventions used:

• infrasound - the impact of low-frequency sound waves;
  
• electrophoresis - under the influence of the ion current is penetrated deep into the tissues of drugs;
• laser therapy - focused on the impact of the laser beam on the problem area;
• ultrahigh frequency - deep penetration of high frequency electromagnetic fields.

The therapeutic effect of physiotherapy:

Title	Result
infrasound	Docked pain, swelling removed, activated motion, improving blood flow to normal metabolism.
electrophoresis	Abate pain, inflammation disappears, to restore the vessels normalizes metabolism.
Laser	It contributes to the rapid recovery of the affected tissues.
ultrahigh frequency	Dulled the pain, reduces swelling, inflammation disappears, normal functioning of cells.

Folk remedies

Treatment of bursitis of the knee joint with the manifestation of its symptoms, we recommend well-tested folk remedies, which include wraps and baths.

Some of them:

1. Recipe 1. Take a few leaves of Kalanchoe, they were carefully washed, placed in the refrigerator overnight. In the morning, pulling the leaves crumple them so that the juice appeared. After that is applied to the knee, are wrapped as a compress, changed every 6 hours. Three days later comes the improvement or bursitis takes place at all.
2. Recipe 2. Take a cabbage leaf, slugger went to the juice. Elbow grease with butter. Applied and knotted sheet scarf. Compress changed daily during the month.
3. Recipe 3. Carefully, without gaps draped knee leaves golden mustache. Tightly knotted. Tool quickly removes the inflammation.

Advised to drink herbal teas, teas made from:

• St. John's wort;
  
• yarrow;
• celery seed.

Help from bursitis bath with pine extract. To do this, collect pine needles, soaked and boiled for about half an hour. Then settled in the course of the night, and is used for baths. Usually the procedure is carried out for 15-20 minutes. The broth is prepared from 0.5 kg of needles 3 liters of water.

Bursitis knee symptoms and treatment which different characteristic features, and treated using the homeopathic preparations.

For example:

• Arnica, Ruta;
• Tiger Balm;
• Traumel C;
• The purpose of T.

Liniments Arnica and Ruta excellent pain reliever. Tiger Balm made based on vegetable components, removes edema. And help eliminate edema during inflammation Purpose Traumel T and C. They are produced in the form of an ointment, drops, solution, granule.

Gymnastics

For the implementation of gymnastic exercises should begin after blocking pain. Start any exercise should be cautious, gradually increasing the time, range of motion, complicating the complex.

Some examples:

1. Lying on his back, hands raised to the top. On the inhale pull up socks limit themselves. On the exhale - socks pulled down.
2. In the same position alternately stretch your heels forward.
3. Hands hold on a trunk level. Alternately, lift your feet up. On the inhale pull the top of the sock. On the exhale lowered.
4. Position - lying flat. In turn, raise the legs, making the move a "bicycle".
   
5. In the supine position on the mat and raise the legs perform a "bicycle" with both feet alternately, toes pointed.
6. In the same position, feet shoulder width apart, bend at the knees. Hugging her knees, pulled up to the head. Head off the floor, to be connected to pull-up knees.
7. Same as the previous, only tighten the two legs together.
8. Side position. One hand up, the other bent. Raise the leg up, pulling on his socks. Securing the top position, as you exhale pull a sock over. Repeat the exercise should be a few times. The same is doing a on the other side.
9. Sitting position. The feet need to deploy and connect. Knees are bred in hand - breathe out. Inspiratory connected.
10. Sitting, one leg bent. Leaning forward, his hands are drawn to the toe of the other leg extended. The same is performed by changing the position of the feet.

All exercises are performed 5-8 times.

Massage

Massage is prescribed only in remission.

Its tasks are:

• take away the pain;
• reduce inflammation;
• enhance tissue nutrition;
• restore function.

Experts hold special methods and rules:

1. The patient lies on her stomach.
2. Unless otherwise noted, each movement is repeated 3-5 times.
3. A session lasts about 20 minutes.
4. When warming or indications used salves, balms, gels, oils.

Basic techniques:

• stroking;
• squeezing;
• shaking;
• kneading;
• trituration.

The work involves:

• palm;
• fingers;
• fingertips;
• fists;
• palm rib.

General machinery bursitis:

1. Beginning with the femoral part. Used consistently: stroking - squeezing - stroking.
2. Motion directed upwards from the knee to the groin. Priority: kneading - shaking - squeezing - stroking - kneading - stroking.
3. Only the front part of the thigh: stroking - shaking - squeezing - shaking - squeezing - kneading - squeezing - kneading.
4. Massage bend (is below).
5. With the knee again, moving to the femoral part and the back knee.
6. Trituration. When the pain is stroking.

Massage the knee area:

1. Rub right knee sliding fingertip (6 times).
2. Make a circular motion, using the same technique (3 times left - 3 - to the right).
3. Specific stroking, pressing in the center.
4. The transition to the thigh: squeezing - kneading - shaking - stroking.
5. Again on the knee. The same 3 doses (40 seconds).
6. Complete massive movements: squeezing the edge of his hand - rubbing his fists.
7. Calming stroking fingers relaxed knee and thigh surfaces.

Contraindications for massage:

• acute form of the disease;
• purulent process;
• damaged skin;
• cardiovascular problems;
• cancer.

bursitis treatment during pregnancy

Bursitis in pregnant women treated by the same methods. Features of treatment are determined by the fact that when pregnancy is undesirable to use a variety of chemicals. Preference is given to folk remedies.

If before pregnancy showed no signs of disease on the joints, it is now possible to have played the role of the following factors:

• 1 and 3 toxicosis trimester;
• food poisoning;
• metabolic disease;
• enhanced load on the locomotor apparatus;
• constrained range of motion;
• infection.

During pregnancy, the acute form of the disease are advised to apply the medication more local. In extreme cases the resorting to removal of exudate followed by introduction of drugs directly into the cavity.

Will greatly benefit preventive measures:

• Restoring the allowable range of motion with the help of medical and preventive exercises.
• The establishment of a balanced and rational nutrition.
• Walks in the open air.
• The use of herbal infusions and decoctions locally.
• Lubrication inflamed joints ointments, prepared on the basis of the plant.
• Abandonment of self, so as not to harm the baby.

Finding the characteristic symptoms of bursitis of the knee joint, it is important not to start the disease, and immediately start treatment, since the delay can cause serious complications, including inflammation, severe pain and restriction mobility.

Registration of the article: Lozinski Oleg

Video of bursitis of the knee joint

What is bursitis of the knee:

Treatment of folk remedies: