Hot, thick, red: When joints swell, there can be many different causes. In addition to overuse or injuries, osteoarthritis, arthritis, and rheumatism are among the primary triggers. What should you do if the swelling doesn’t go down?

Symptoms and diagnosis

Possible symptoms of joint effusions include swelling, pain, overheating, redness and limitations in functionality or mobility.

The first step in properly treating a swollen joint is to determine what caused the effusion. This is usually done by interviewing the patient, conducting a clinical examination, and performing laboratory tests, X-rays, ultrasound, and MRI.

In addition to injuries and overuse, swelling can also have less obvious causes: “There are a whole range of diseases that can be associated with increased fluid accumulation in the joint, e.g., inflammatory rheumatic diseases, but also activated osteoarthritis, metabolic diseases such as gout, infections, injuries and very rarely joint tumors

Color of synovial fluid changes after illness

If the origin of the effusion is unclear, synovial fluid is taken using a puncture. Its composition allows initial conclusions to be drawn. “Normal synovial fluid is straw-yellow and clear, but in inflammatory rheumatic diseases, it is a lighter yellow and cloudy to flaky,” explains Lorenz. “In gout, you tend to find a milky-looking synovial effusion, while in acute infections, the fluid is often creamy. After acute injuries involving joint structures, the synovial effusion is bloody.”

When cooling and storing up high, it still helps.

In the case of swelling that is accompanied by inflammation and thus often overheating in the joint, the symptoms can often be alleviated simply by cooling. “In addition, rest and possibly elevating the affected joint can be sufficient to improve the symptoms,” adds Lorenz.

In the short term, bandages and orthoses can be used to immobilize the joint and thus reduce pain. However, these should not be worn for too long in order to avoid permanently restricting the mobility of the joint. In any case, the decisive factor is and remains the appropriate treatment of the underlying disease.

Gout: Think long-term

If, however, the patient is suffering from an acute attack of gout, cooling, immobilization, and medication are indicated. For example, anti-inflammatory drugs and colchicine or cortisone should be taken until the symptoms subside. In the long term, those affected should adjust their diet by consuming less meat and alcohol, but also less fructose, which is contained in fruit juices or smoothies

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