Arthritis of the knee is widespread: its evolution and consequences.
Septic arthritis such as:
- Gonococcal arthritis,
- Lyme disease,
- Tubercular arthritis,
- Arthritis of streptococcal origin,
- Arthritis of staphylococcal origin,
Aseptic arthritis, such as :
- Rheumatoid arthritis (rarely at first). ,
- Rheumatic fever,
- Ankylosing spondylitis (in 85-90% of HLA B27 carriers)
- Psoriatic arthritis,
Microcrystalline arthritis, such as :
- Gout disease,
- Chondrocalcinosis,
- Tumour arthritis,
- Villonodular synovitis primarily affects the knee.
The knee is the joint most affected by septic arthritis.
Clinical signs of septic arthritis
Pain :
- Intense,
- Sudden onset,
- Constant,
- Leading to functional impotence,
A knee :
- Swollen,
- Hot,
- Red (from pink to purple depending on the degree of inflammation).
A complicated physical examination
Radiological examination: signs of this type of arthritis
- Global pinching of the joint space (between the femur and the tibia and between the femur and the patella)
- An intra-articular effusion,
- A thickening of the soft parts,
- Demineralization,
- Cartilage damage.
Physical examination: cloudy synovial fluid and the presence of a germ.
- Cloudy (even purulent),
- It contains numerous polynuclear white blood cells (over 95%).
- Staphylococcus aureus: In the vast majority of cases,
- Kingella kingae (an embryo that is difficult to isolate but very often involved),
- Pneumococcus from an ENT or pulmonary infection,
- Streptococcus, also from ENT or dental infections,
- Gram-negative bacteria after an intestinal or genital infection.
Arthritis of the knee: cases of aseptic arthritis
Aseptic arthritis does not have the same symptoms as septic arthritis.
Symptoms of this type of knee arthritis include: progressive pain
Knee pain:
- Less violent than septic or microcrystalline arthritis,
- With a progressive onset,
- Evolving for more than six weeks,
- Predominantly during the second half of the night,
Morning stiffness.
Signs visible on radiological examination.
Knee involvement in microcrystalline arthritis
Severe symptoms
- Pain :
- Sudden onset,
- Violent,
- Inflammatory,
- Articular or close to the joint,
- Functional impotence.
Arthritis of the knee in case of gout or chondrocalcinosis
- A history of microcrystalline arthritis affecting the big toe or foot
- A history of urinary lithiasis (crystals in the urinary tract)
- Hyperuricemia (abnormally high presence of uric acid in the blood).
- Mainly concerns older women,
- Has the particularity of leading to destructive arthrosis between the femur and the patella in the knee.
Physical examination and microcrystalline arthritis
- The big toe (hallux),
- The Achilles tendon (calcaneal tendon)
- Elbows,
- Fingers,
- The auricles of the ears.
Imaging: signs of gout and chondrocalcinosis
Biological examinations
- The presence of microcrystals (sodium urate and calcium pyrophosphate, respectively) in the punctured joint fluid
- An increase in the sedimentation rate (SV).
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