Balleting syndrome of the patella. Symptoms of a floating patella: Causes of the disease, clinical picture, diagnostics of patephalnant running syndrome

07.06.2021 Gardening

Balleting of the patella is a pathological oscillation of seismine bone, which is part of the knee joint. This symptom most often means the pathological accumulation of fluid (synovial, blood) in the articular cavity. Also in some cases, the chain of the patella can be, with the gelatinous swelling of the synovial shell.

Such a condition may accompany injuries and inflammatory-degenerative diseases of the joint. If such a symptom occurs, it is necessary to immediately seek qualified medical care.

Features anatomy

The patella is the largest seamovoid bone in the human body. It is distinguished by the fact that it is not attached to the parts of the joint, bone or muscles.

The patella is located in the thickening of the four-headed muscles of the thigh, and in the tendon. This bone is perfectly prone through the skin, as well as with a dispere knee, quite moving. Thanks to this education, it becomes possible to prevent the displacement of the surface of the tibial and femoral bone to the parties.

Ballotting of the patella is becoming possible due to the characteristics of the joint structure. After all, when fixing to one of the more "stable" formations, the blowing of the bone would be completely impossible.

Main reasons

The "floating" patella can occur during acute and chronic diseases of the joint of a specific and non-specific nature, sports and domestic injuries. All these states may be accompanied by an increase in the amount of sinerisutic fluid. To the most frequent reasons include:

osteoarthritis;
productive inflammatory processes;
hydartrosis or Watercolka;
acute or chronic injury;
violation of the integrity of joints and elements of the joint.

Especially attentive should be in the diagnosis of types of injuries. Such a symptom is a sign of a trauma of meniscus, anterior or rear cross-shaped ligaments or a synovial shell.

Clinical picture

When running the patella

At least running the patella and is considered only a symptom of many other pathological conditions, he has its pronounced clinical picture.

The first manifestations include the pronounced pain syndrome, which appears at the beginning during movements, and after and alone.

The intensity of sensations directly depends on the amount of fluid: if its volume is up to 15 ml, then discomfort, may occur only after a few days.

Mobility restriction appears not immediately. In progression of the state, patients note violation of extension, the formation of contracture in a semi-bent state. With a large number of traffic, the joint is smoothed, and the knee is significantly increasing in the volume compared to the healthy limit.

Principles of diagnosis

To identify the symptom of the floating brine, the patient must be put on the back, rectifting the damaged limb. The doctor fixes the fabrics with one hand just above the joint, and the other is trying to "drown" the patelter inside. Normally, it is impossible to perform this, and when the excess fluid is accumulated, the book is "leaving" until it is stored in the femoral bone.

A brush of one hand doctor records the upper breakdown, which is located above the patella, thereby "squeezing" the free fluid of the book. The fingers of the second hand must be forgiving the gap between the knee and the tibia.

It is necessary to plunge the fabric from all sides, trying to determine the presence of seals, swelling, "unsubstate". It is worth noting that pathological formations are easier to determine from the inside.

In the absence of pathologies, the synovial shell does not fit.

Principles of treatment

It is not necessary to deal with the treatment of a floating patella, because it is just the manifestation of the underlying disease. To identify this, it is necessary to carry out additional research methods, namely, computer and magnetic resonance imaging or ultrasound examination of the joint cavity.

After the doctor determines the reason for running the patella and accumulate excessive fluid, it is necessary to assign treatment. Depending on the type of pathology, a special list of activities are carried out:

removal of liquid with arthroscopic or puncture method;
use of aseptic solutions for washing;
the introduction of medicinal substances in the body cavity;
temporary immobilization of soft or solid dressing material;
limiting mobility;
medical physical culture, physiotherapeutic methods.

You should also try to prevent the subsequent trauma of the joint. To do this, use a patella or an elastic bandage. Sport classes can be resumed only after complete tissue restoration, while consulting with experienced coaches.

Treatment of the pneeling chain, perhaps only when eliminating the main cause of the disease. There is no need to correct the clinical manifestation of the disease, without interfering with its pathogenesis.

Source: https://nogostop.ru/koleno/ballotirovanie-nadkolennika.html

Knee Cup: Photo, Symptom of Phalannik Ballotting and Other Problems

The knee cup performs an important function in the knee joint - the most complex articulation in the human body. At first glance, the patella seems to be such an important organ, but injuries and damage to the knee cup do not pass without a trace.

Development and Anomalies of the Knee Cup

The knee cup (patella) - the bone, located above the knee joint in the layers of the tendons of the four-headed muscle. The patella is one of the sesamoidal (from Greek. "Sesamon" -cungent, that is - similar to sesame seeds) bones. The top area of \u200b\u200bthe patella is called the base of the patella.

The bone moves if the knee is dispersed - it can be shifted to the sides.

The patella performs several functions:

Protects the femoral and bone from shifting them to the side when flexing, due to the structure - from the bottom of the patella, in its top, there is a protrusion.
Performs a function of a kind of addition to a four-headed muscle, thereby simplifying bending, allows you to move easier.

The development of bone tissue begins from the second month of pregnancy, the specialists believe that the configuration of the knee-base appear on the 20-22 week of pregnancy, while it consists of cartilage tissue, which remains at the time when the baby must be born. Therefore, it is believed that children are born without knee cups.

But the jacket there are osening zones that are actively starting to work only from the 2-year-old age of the child, a finally a patella is formed only by 5-6 years.

That is, the children should be born with the inclines of the knee cup, the absence of this element or its underdevelopment is not the norm.

The knee cup may not be?

The absence of a patella is not frequent pathology, it is found in only 6% of cases, if at the same time there is underdevelopment of the femur and its muscles, and in just 2% of cases as a single problem.

If the reasons for the improper development of the limb are carried out in childhood operations to eliminate problems. If there is no patellane, and all other components are normal, usually the functions of the limbs are not violated and the treatment is not required in this case. The knee does not hurt, but the child can feel some discomfort and fast feet fatigue. Visual defect will be noticeable.

Dislocation of the patella is congenital

Most often, the unfair man learns about the congenital dislocation of the patella (if he is not pronounced), only at the inspection of an orthopedic or rheumatologist - such an anomaly makes it necessary to know about its own existence of an unpleasant tension in the prefabricated area and fast foot fatigue. With an obvious problem, a person complains about instability.

Over time, pathology develops, dislocation of the patella leads to such consequences:

movements are dramatically limited;
strong pains begin with limb bending;
the ankle is deviating to the outside, causing a lot of inconvenience.

The problem is solved by conducting an operation.

For reference! Congenital patella dislocation is 85% more often detected in boys than girls.

Podphalnik

Such a patella of normal sizes, but consists of several elements that connect ligaments. More often, no problems cause a condition, and they detect it on an x-ray completely accidentally. Therefore, the percentage of such pathology is less than 2%.

No matter therapy is not required, experts can limit only physical stress on the knee joint. Anomaly can lead to the development of degenerative diseases.

For reference! Also, underdevelopment of the stationary of the patella, underdevelopment of its protrusion. Such pathologies require immediate treatment.

Acquired pathology

If congenital anomalies underdevelopment of the patella are found in total of only 6% of cases, then with the problems acquired, everything is much more complicated and large. Damage to the knee of the knee according to statistics is observed in 45% of cases.

At the same time, as well as with problems in innocent, damage is more often several times in men aged 25 years.

For acquired pathologies, the knee hurts and reports problems with other symptoms.

Dislocation

Dislocation of the patella acquired - the result of the injury of the limb and a poorly developed binder, is found in 1-2% of the dislocations of all structures.

Traumatologists distinguish the acute form of dislocation when the symptoms are pronounced brightly, there is a bruise of the affected area, and the solar, in which the symptoms are not obvious, but constant.

Classify dislocation by type of displacement, distinguish them in this way:

Side dislocation. It is divided into the outer side, when the patella is shifted to the outer region, and the inner side when the transition occurs to the inside. The limb is in the dispere state.
Torsion dislocation. Another name is rotary. There is a turn of the knee cup horizontally - the degree of reversal depends on the strength of the injury.
Vertical dislocation. The most unpleasant and rare type - there is a turn of a cup by vertical in such a way that some kind of its edge is located in the area between the berth and the femoral bone. In this case, there is a strong swelling in the popliteal area.

In rare cases, it is possible to independently affect the knee cup back - due to the ligament apparatus and muscle action. However, more often without the help of a traumatologist could not do.

In ambulance, it is necessary to contact if such symptoms are observed:

sharp pain in bending;
it is impossible to completely disperse the knee;
movements are completely limited;
swelling.

At the same time, it is possible to see some breeding in the area of \u200b\u200bthe knee joint - the skin of the rear region of the limb is stretched, and the skin is formed in the front.

Treatment is usually carried out by refueling a cup to a place under anesthesia. It is then shown immobilization up to 2 months, such methods are used as auxiliary therapy:

physiotherapy;
reflexology;
massage.

With acute dislocation, any actions with the limb begin after 2-4 weeks of rest regimen. The limb is immobilized.

Sometimes when dislocation of the patella can occur a bundle of a patella or nearby knee ligaments, while doctors perform therapeutic actions aimed at restoring ligaments.

Important! The function of the knee is restored after 1.5 - 3 months.

Fracture

Cases of the patella fracture not more than 25% of the total number of fractures, according to statistics, active children and people from 40 years are prone to such troubles.

The wreck is engaged in the presence in the knee joint. Defined palpation of the patella.

Baer Symptom

The appearance of pain in sacral-iliac joints when pressed on this area through the abdominal wall. It is observed in pathological changes in these joints.

Symptom of the "drawer"

One hand is taken for the shin of the ankle joint, the other - the palm surface is pressed on the upper third of the ion-colored muscle. When the cruciform ligaments are broken, the shin is shifted forward.

Hutter Symptom

It is expressed in the difference of force of bending during the pronion and supination of the forearm and is noted when the double-headed muscle is broken.

Comolly symptom, or symptom of "triangular pillows"

Titce Syndrome (Titz's Illness)

Tumor-like growth of the cartilage part of one, less often 2-3 ribs at the connection of them with a sternum with a pronounced pain at the moment of sneezing, cough, with a deep breath.

Felty Syndrome (illness)

It is characterized by chronic inflammation of the joints, an increase in spleen, anemia, leukopenia and thromboenia, hyperproteinemia and disproteinemia. Meets in women. Etiology is unknown.

Barre-Massone disease

It is expressed in vegetionerevulgia caused by a neoplasm outgoing from the vascular gloms of the end phalange of the fingers. In a limited section, the end phalange of the finger and sometimes under the nails appears soreness, a tumor of a rounded shape, a diameter of up to 5-6 mm.

Bekhtereva disease

Inflammation of the small joint joints of the spine, usually begins with a sacratling and ileum. There comes to decalcification of the vertebrae. Initially, pain symptoms are dominated, and then the symptoms of arthrodesis and the so-called "posture of Lazarus standing out of the coffin". X-ray is determined by a typical symptom of the "bamboo stick", ankylosing spondylitrite.

Gaberden Disease, Gabdeni Knot

Nature seals on the end phalanges of the brush, dense, more often symmetrical. The formation of the nodules is preceded by paresthesia and anemia of the fingers. X-ray is determined by the narrowing of the articular slots and the edge bone prolipe.

Duplea disease

It is characterized by painful, limited movements in the shoulder joint. The most painful lead and rotation inside. Often it is found in the tendons near the joint. It is found mainly in older women, develops as a result of injury.

Dupuitren Contracture

Thickening and contracture of the palm aponeurosis 4-5 fingers, more often right, but maybe both hands. Meets in individuals involved in physical labor.

Outragia bone atrophy

It develops after injury and diverse inflammatory diseases of bones, joints, tendons, nerves. There is a pronounced bone atrophy and their increased fragility. Such atrophic changes are noted in the skin and muscles. Evenkes of stop and brushes are formed. The skin becomes cyanotic, her temperature drops.

Kosy Sarcoma

Tumors are localized in the distal limbs, can be placed symmetrically. Initially, multiple skin tumors appear with a pea and having a bluish, sometimes blue or dark color, can be bleeding, some scarce. Lymphatic nodes are not affected, but metastasis can be observed in the lungs and in the digestive tract.

Kashin-Bek disease

Dystrophic non-infectious metabolic arthritis. Osteochondropathy heads of 2 × 3rd tie bones.

Keller's disease

Aseptic necrosis heads 2-3 tie bones. Girls at the age of 12-16 are 4 times more often than boys.

Kenigi disease

It is characteristic that a wedge piece of bone is separated from the total mass of the medial model and the corresponding defect form is formed in this place. Arises as a result of an embolocal infarction of the branches of the middle patellied artery.

Kinbeck disease

Osteochondropathy semi-lunged wrist.

Lega-Calwe-Perthes disease

It is osteochondropathy of the head of the femoral bone. The disease is developing mainly in youthful and childhood, and the boys are 5-6 times more often than girls. In the initial period, the disease proceeds asymptomaticly, then a small chromoty and pain appear. Pains are often irradiating into the knee joint, increase after walking, but, unlike Koksita, this disease is easily proceeded, the body temperature does not increase, impudations and ankyloses are not observed, the picture of the blood does not change. X-ray - disappearance or sealing of the hip head. The disease lasts 6-7 years and ends with deformation of the head.

Lermitta disease

Weakening and sealing of the muscles of the lower extremities with subsequent contractures. Mostly observed in older women.

Little disease

Children's double-sided hemiplegia. The patient can only move with the help of crutches on the tips of the fingers with the twisted heels of the duck and pressed with each other knees. The cause is a long-term asphyxia during labor with hemorrhages in the brain substance, intracranial injuries and diseases of the mother during pregnancy.

Marie Disease, Marie-Bamberg Syndrome

It is expressed in general thickening and sclerosis of long tubular bones, as well as in a kind of flask-shaped thickening of the nail phalanx of the fingers taking the view

Marble disease

Congenital systemic abnormal skeleton. It is characterized by diffuse sclerosis in the bones of the skeleton. Radiologically in the bones there are structural white (marble) stains.

Mullegete disease

In the knee joint, the effusion is formed, leading to the complete immobileness of the latter.

Albright Disease

Pellygrini-pin sickness

Sorry of soft tissues in the field of internal thighs as a result of the injury of the knee joint.

Putty disease

Degeneration of one intervertebral cartilage. It is manifested by pools in the lumbar region with irradiation into the lower limbs by type of inflammation of the sciatic nerve.

Still disease

Infectious inflammatory diseases of the joints.

Randy Muller's disease

Nurses of the Sesamon Bone of the Big Foot.

Taratynova disease

Eosinophilic granuloma bones. Radiologically detected single small defects in the bones. Points contain granulomas of eosinophils up to 30-50%.

Stripell Behtereva-Marie Illness

Ankylosing spondylitrite of unclear etiology.

Shuller-chrischene disease, lipograntomatosis

It is characterized by classical triad symptoms: bone defects, exophthalm and polyuria. There arises in children in the first years of life.

Podgeletta disease

Increase and elongation of affected bones. X-ray: the presence of multiple bone cysts, hyperbate and osteosclerosis.

Balloting of the patella

(Patella Natans) Sign of the cluster of the fluid in the breakage of the knee joint: with a straightened limb, pressed on the patellite causes its immersion in the body cavity until it stops into the bone, after stopping the pressure of the patella "pops up.

Medical terms. 2012

Four main symptoms

The main symptoms of the hemarity of the knee joint:

restriction of movement in the knee,

changing the shape of the joint,

specific symptom of "balllotting" ("navigation") of the patella.

1. Pain

The intensity of the pain in the knee is closely related to the amount of accumulated blood: with a small hemorrhage (up to 15 ml - this is 1 degree of hemarrosis) at first may not be, but with massive hemorrhage (2 degree (up to 100 ml) and 3 degree (more than 100 ml )) Acute pain occurs immediately after injury and subsequently increases. But even small amounts of blood cause irritation of the synovial shell (the inner layer of the articular bag), traumatic synovit (inflammation of the synovial shell) and the appearance of pain in a few days after injury.

If the knee is touching the traumatologist, the victims feel sharp pain, including at 1 hemarrosis degree.

2. Restriction of movements

Due to pain and blood clusters, the normal joint function is disturbed. This is especially noticeable when performing extension, which becomes extremely painful, and sometimes impossible. Some patients develop a bending contracture (the foot is fixed in a half-bent position). It is also hampered by walking and supporting leg.

3. Changing the shape of the knee

The shape of the knee varies at large quantities of the blood joints overlooking the inside (15 ml or more). Such a blood cluster presses from the inside to the patella, protruding it, which is accompanied by the smoothing of the knee contours, an increase in its size compared to healthy.

Small hemorrhages are usually not manifested.

Significant hemorrhage in the kingdom of the knee joint

4. "Balllorination" of the patella

The hemarthrosis of the knee joint 2 and 3 degrees (with the volume of hemorrhage more than 15 ml) is accompanied by the symptom of the "balllorination" or "navigation" of the patella. In the position of the patient lying on his back or sitting with the foot straightened in her knee, the doctor presses his fingers on the patella, as if trying to press him deep into, and then removes his hand. In the presence of fluid in the cavity of the joint, the patella is immersed in this liquid ("sink"), it hits the bone protrusions and, after stopping the pressure, "pops up".

Diagnostics

In addition to specifying the preceding injury and inspection, to clarify the diagnosis use:

puncture of the knee joint;

radiography;

arthroscopy;

Ultrasound, CT and MRI.

1. Puncture

The puncture of the knee joint is the procedure for diagnostic and at the same time therapeutic. It is carried out under local anesthesia (make anesthesia using novocaine chips or lidocaine into soft tissues around the place of puncture) with a thick needle that is injected into the joint. After entering the cavity of the joint, the doctor pulls the piston of the syringe and estimates the liquid flowing there:

(if the table is not completely visible - leaf it right)

2. Radiography

The hentgen of the knee in two projections allows to detect an intra-articular fracture (fracture of bones forming the knee joint, inside the custody of the joint).

3. Arthroscopy.

Arthroscopy is a medical and diagnostic small-acting operation, which is carried out using the arthroscope (apparatus, allowing to see from the inside the joint cavity). The arthroscope is injected into the knee joint through a small cut. If necessary, remove damaged tissues make another incision through which the surgeon enters the tools and extracts scraps of cartilage or other dead fabrics.

4. Other methods

Ultrasound, CT, MRIs are used additionally to clarify the nature of damage caused by bleeding.

Possible complications

Later, the beginning of the treatment of hemarrosis can lead to complications:

infection of the articular cavity;
post-infectious arthritis (joint inflammation) and other inflammatory processes in the field of knee (synovitis, bursitis);
gonarthrosis (chronic disease with knee deformation and impaired its work);
spikes and scars inside the joint, limiting its functionality.

Five treatment methods

In case of injury to the knee and appearance after injury of severe pain, and even more so problems with movements in the knee joint - it is necessary to refer to a traumatologist who will conduct a study and prescribe treatment.

For the treatment of hemarosis of the knee joint, five procedures perform:

Removal of blood from the custody of the joint with the help of puncture or arthroscopy. During the procedure, the articular cavity is washed with novocaine and antiseptics.

Immobilization of the knee (fixed in a fixed state) with the help of plaster longs (long plaster stripes) for 2 weeks and restricting the load on foot for 4 days.

Treatment of the causes of hemarrosis: bundles of bundles, meniscus, intra-articular fracture (if available).

Therapeutic gymnastics directly in the fixing bandage: the stress-relaxation of the muscles of the thigh and the tibia without active movements, active movements in the hip joint.

Physiotherapy: laser, magnetic treatment and other procedures (no earlier than a week from injury).

Prevention

The hemarthrosis of the knee joint is a familiar state not only for patients with diseases of the blood coagulation system, but also for healthy people who have increased the risk of knee injury. First of all, these are athletes engaged in figure skating and skating sports, athletics, football and hockey, skiing, roller skating.

For athletes, Gemearzz prevention is observing safety regulations and the use of knee pads, which at times reduce the likelihood of serious injury. For other persons, as a measure of the prevention of household injury (for example, falling on a slippery road) can be careful and attentiveness when walking and running.

Conclusion

Hemartrosis is a frequent complication of knee injuries. This is not an independent diagnosis, and one of the symptoms of damage to the joint, so for treatment it is necessary to find out the root cause of the state. The examination during hemarthritz conducts only a traumatologist, he also prescribes and performs the necessary healing manipulations. In no case cannot ignore post-traumatic knee pain - the solar hemarthrosis can be complicated by severe pathologies and lead to immobility in the knee joint.

Owner and responsible for the site and content: Athenogenov Aleksey.

Bulling is the oscillation of dense education (organ, tumor, etc.), determined when it. It is found particularly noticeable if there is fluid next to the rolling formation or around it. A distinct balloting of the mobile tumor of the abdominal cavity (outgoing, for example, from large) indicates the developed. Less noticeably running enlarged; It is manifested by the fact that the push with one hand from the front side is transmitted by another hand, subplated under the lower back, and back.

The most important is the symptom of running a patella - a symptom of a floating brown cup, as it is found in the most slight accumulation of fluid (effusion, blood) in. In the study of the patient, the patient falls on the back with a straightened knee, the investigating puts the ends of the fingertips of the right hand to the knee cup (Fig.) And trying to immerse it deep into ("drown"), which normally fails. When the fluid is accumulated in the joint, the patella "sink" - goes deep, until it flips into the surface, and the pressure of the pressure "pops up" as the spring pushed. To discover running a patella with scarcels, it is necessary to leave the region of the top coating of the knee joint with the left hand and thus squeeze the fluid under the patella.

Ballotting (from Franz. Balloter - fluctuate, swing) - the phenomenon of oscillations or displacement of the dense body or organ (with returning it to its original position) in one of the body cavities. Bulling is particularly well expressed when the dense body (organ) is in a liquid medium. Bulling gives a feeling of a push with a renovation.

The running is caused by short, peasant blows of the tips of the bent fingers along the dense body through the wall of the cavity. In some cases, the balloting of organs is determined when they are tight. Bulloching is an important diagnostic feature, it often indicates a cluster of fluid in the cavity.

In the abdominal cavity, in the presence of fluid, it is possible to raise the rolling tumors emanating from the large gland, the mesenter of the intestines and ovaries. With kidney tumors, the balloting can be caused by short shocks of the hand along the corresponding side of the lumbar region and determine the other hand put on the same half of the abdomen (right or left). When drawing or hemorrhage into the kole of the knee joint, the knee cup is observed; With a lot of traffic, it can be accompanied by a well-harshable knock from the strike of the knee cup about the articular ends of the bones ("Patella Natans" - a floating patella). With little effusion, the patellane can be detected if the other hand to grind the upper turn of the knee joint to squeeze the liquid from it.