Joint Swelling
Look For
- Generalised swelling over one or both lower limbs. May be associated with redness, tenderness or warmth.
Significance
- May be a sign of an intra-articular bleed.
Causes of Joint Swelling
- Intra-articular haemorrhage
- Arthritis - osteoarthritis, rheumatoid arthritis, septic arthritis, gout, pseudogout, reactive arthritis, psoriatic arthritis
- Trauma - fracture, dislocation, muscle sprain or rupture, compartment syndrome
- Skin / soft tissue infection - cellulitis, abscess
- Vascular - acute ischaemia, DVT, superficial thrombophlebitis, venous insufficiency, lymphoedema
- Systemic - heart failure, cirrhosis, nephrotic syndrome, malnutrition
- Tendinitis / bursitis
Joint Range of Motion
How to Assess
- Ask the patient to move the joint themselves, and then passively move it for them. Note the range of motion and whether it is limited by pain, swelling or stiffness
Significance
- May be a sign of an intra-articular bleed.
Causes of Limited Range of Motion
- Intra-articular haemorrhage
- Arthritis - osteoarthritis, rheumatoid arthritis, septic arthritis, gout, pseudogout, reactive arthritis, psoriatic arthritis, Reiter's syndrome
- Trauma - dislocation, fracture, ligamentous / menisceal tear
- Loose intra-articular body
- Fibrous adhesions
- Muscle tightness
- Prolonged joint immobilisation
- Compartment syndrome
- Tendinitis / bursitis
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