Swollen Joints: Why a Joint Swells and What a Visit Can Sort Out

What it involves

MedlinePlus defines joint swelling as the buildup of fluid in the soft tissue around a joint or in the joint itself. It says the swelling may make the joint look larger or abnormally shaped, can come with pain or stiffness, and often occurs along with joint pain.

Who this is for

• Adults with a swollen knee, ankle, wrist, finger or other joint
• Patients whose joint swelling came on without an injury
• People with joint stiffness, warmth or redness that keeps coming back
• Adults with a swollen joint after a fall or twist who are unsure whether it needs to be seen

What to expect

• Questions about when the swelling began, how long it has lasted and whether it comes and goes
• An exam of the swollen joint and the joints around it, including range of motion
• Blood tests when your provider suspects arthritis or another condition
• A referral for joint X-rays, fluid testing or a specialist if the cause calls for it

Swelling after an injury

MedlinePlus says that after an injury, swelling of a joint may mean a broken bone or a tear in a muscle tendon or ligament. For swelling after an injury, home care means applying ice packs wrapped in a cloth, never directly on the skin, and raising the joint above the level of the heart if possible. A swollen ankle, for example, can rest on pillows while you lie down. Swelling that follows an injury is one of the reasons it lists for contacting a provider, so a joint that balloons after a fall should be examined.

Swelling without an injury

When swelling appears on its own, MedlinePlus lists many possible causes. They include osteoarthritis from wear and tear, gout from uric acid crystals, pseudogout from calcium-type crystals, rheumatoid arthritis, psoriatic arthritis, reactive arthritis, ankylosing spondylitis, systemic lupus erythematosus and septic arthritis, which is a joint infection. Telling these apart is the main job of the visit. The osteoarthritis guide describes the most common one, and the knee pain guide describes how knee swelling is usually worked through.

Warmth, redness and fever

MedlinePlus notes that many types of arthritis cause swelling, redness or warmth around the joint, and that an infection in the joint can cause swelling, pain and fever. It says to contact your provider right away if you have joint pain and swelling with a fever. This is the combination that should not be left for a routine appointment, and a same-day call to the office is the right first step. Do not try to drain or lance a swollen joint at home, and do not assume that ice alone will settle a hot, red joint.

What the exam and testing can involve

The encyclopedia says your provider will examine the joint closely and ask when the swelling began, how long it has lasted, whether it is constant or comes and goes, and what you have tried at home. Tests to find the cause may include blood tests, joint X-rays, and joint aspiration with examination of the joint fluid. At Serenity By A Dr. Sareen, the exam and blood work are part of the visit. X-rays and fluid testing would be ordered or referred, and the provider can explain which one fits your situation.

Treating the cause, and joint injections

MedlinePlus says that if you have arthritis, you should follow your provider's treatment plan, and that physical therapy for muscle and joint rehabilitation may be recommended. Treatment depends entirely on the cause, which is why identifying it comes first. Serenity By A Dr. Sareen offers joint injections at its Loxahatchee and West Palm Beach offices, which a provider may discuss for some joint conditions after an evaluation. Whether an injection suits a swollen joint is a clinical decision, and an infected joint is not treated that way.

When to contact the office

MedlinePlus lists unexplained joint swelling and joint swelling after an injury as reasons to contact a provider, and joint pain and swelling with a fever as a reason to do so right away. Add to that a joint you cannot move or put weight on, or one that looks out of shape after a fall, which needs urgent care. If several joints swell at once, or swelling returns repeatedly, tell the provider, since the pattern can point toward a body-wide condition. The gout guide describes one of the most common causes of a sudden hot joint.

Sources

• MedlinePlus — Joint swelling (medical encyclopedia)
• MedlinePlus — Joint Disorders (health topic)