Arthritis und Rheuma 2018; 38(03): 163-175
DOI: 10.1055/s-0038-1660906
Rheuma – vom Symptom zur Diagnose
Schattauer GmbH

Das geschwollene Knie

The swollen knee
H. Bastian
1   Abteilung Rheumatologie und Klinische Immunologie, Immanuel Krankenhaus Berlin, Standort Berlin-Wannsee
,
M. W. Jagielski
2   Klinik für Orthopädische, Unfall- und Wiederherstellungschirurgie, Charité – Universitätsmedizin Berlin, CBF – Campus Benjamin Franklin, Berlin
,
S. Arens
2   Klinik für Orthopädische, Unfall- und Wiederherstellungschirurgie, Charité – Universitätsmedizin Berlin, CBF – Campus Benjamin Franklin, Berlin
,
E. Feist
3   Klinik für Rheumatologie und Klinische Immunologie, Charité – Universitätsmedizin Berlin, Berlin
› Author Affiliations
Further Information

Publication History

Publication Date:
01 June 2018 (online)

Zusammenfassung

Das geschwollene Kniegelenk ist in der orthopädischen und rheumatologischen Praxis vergleichsweise häufig anzutreffen. Betroffene Patienten erleben eine erhebliche Einschränkung ihrer Lebensqualität und Produktivität. Auf der einen Seite ist das Kniegelenk aufgrund seines anatomischen Aufbaus und seiner Funktion anfällig für Verschleiß und Verletzung, zum anderen ist es, unabhängig von degenerativen Veränderungen und traumatischen Ereignissen, häufig von entzündlichen Erkrankungen betroffen. In Abhängigkeit von z. B. Alter des Patienten, Beginn und Dauer der Beschwerden kommen eine Reihe von Diagnosen in Betracht. Dieser Artikel widmet sich schwerpunktmäßig der Differenzialdiagnostik von Kniegelenksschwellungen und beschreibt die typischen

Summary

The swollen knee is a frequent finding in the daily praxis of orthopedics and rheumatologists. Affected patients often report a significant reduction of their quality of life and productivity. In fact, the knee is prone to deterioration and injury, but also in addition to inflammatory diseases. Depending e. g. on the age of the patient, onset and duration of symptoms several diagnosis should be considered. This article focuses on the differential diagnosis of the swelling of the knee and describes the typical clinical, laboratory and imaging findings.

 
  • Literatur

  • 1 Liao ST, Chiou CS, Chang CC. Pathology associated to the Baker’s cysts: a musculoskeletal ultrasound study. Clinical rheumatology 2010; 29 (09) 1043-1047.
  • 2 Andonopoulos AP, Yarmenitis S, Sfountouris H. et al. Baker’s cyst in rheumatoid arthritis: an ultrasonographic study with a high resolution technique. Clinical and experimental rheumatology 1995; 13 (05) 633-636.
  • 3 Ospelt C, Bang H, Feist E. et al. Carbamylation of vimentin is inducible by smoking and represents an independent autoantigen in rheumatoid arthritis. Annals of the rheumatic diseases 2017; 76 (07) 1176-1183.
  • 4 Ajeganova S, van Steenbergen HW, Verheul MK. et al. The association between anti-carbamylated protein (anti-CarP) antibodies and radiographic progression in early rheumatoid arthritis: a study exploring replication and the added value to ACPA and rheumatoid factor. Annals of the rheumatic diseases 2017; 76 (01) 112-118.
  • 5 Truchetet ME, Dublanc S, Barnetche T. et al. Association of the Presence of Anti-Carbamylated Protein Antibodies in Early Arthritis With a Poorer Clinical and Radiologic Outcome: Data From the French ESPOIR Cohort. Arthritis & rheumatology 2017; 69 (12) 2292-2302.
  • 6 McQueen FM. Imaging in early rheumatoid arthritis. Best practice & research. Clinical rheumatology 2013; 27 (04) 499-522.
  • 7 Hartung W, Kellner H, Strunk J. et al. Development and evaluation of a novel ultrasound score for large joints in rheumatoid arthritis: one year of experience in daily clinical practice. Arthritis care & research 2012; 64 (05) 675-682.
  • 8 Naredo E, Gamero F, Bonilla G. et al. Ultrasonographic assessment of inflammatory activity in rheumatoid arthritis: comparison of extended versus reduced joint evaluation. Clinical and experimental rheumatology 2005; 23 (06) 881-884.
  • 9 Schafer VS, Schmidt WA, Backhaus M, Hartung W. Arthritis of the Knee Joint in Rheumatoid Arthritis – Evaluation of Treatment Response by Ultrasound in Daily Clinical Practice. The open rheumatology journal 2016; 10: 81-87.
  • 10 Koizumi F, Matsuno H, Wakaki K. et al. Synovitis in rheumatoid arthritis: scoring of characteristic histopathological features. Pathology international 1999; 49 (04) 298-304.
  • 11 Seitz S, Ruther W. [Postoperative management of hip and knee endoprostheses]. Zeitschrift fur Rheumatologie 2012; 71 (08) 670-679.
  • 12 Lu MC, Tung CH, Yang CC. et al. Incident osteoarthritis and osteoarthritis-related joint replacement surgery in patients with ankylosing spondylitis: A secondary cohort analysis of a nationwide, population-based health claims database. PloS one 2017; 12 (11) e0187594.
  • 13 Kiltz U, Baraliakos X, Braun J. [Management of axial spondyloarthritis]. Der Internist 2016; 57 (11) 1060-1068.
  • 14 Rihl M. [Update on reactive arthritis]. Zeitschrift fur Rheumatologie 2016; 75 (09) 869-877.
  • 15 Rudwaleit M. [Spondyloarthritides]. Zeitschrift fur Rheumatologie 2017; 76 (10) 889-903.
  • 16 Sieper J, van der Heijde D, Landewe R. et al. New criteria for inflammatory back pain in patients with chronic back pain: a real patient exercise by experts from the Assessment of SpondyloArthritis international Society (ASAS). Annals of the rheumatic diseases 2009; 68 (06) 784-788.
  • 17 Baerlecken NT, Nothdorft S, Stummvoll GH. et al. Autoantibodies against CD74 in spondyloarthritis. Annals of the rheumatic diseases 2014; 73 (06) 1211-1214.
  • 18 Emad Y, Ragab Y, Bassyouni I. et al. Enthesitis and related changes in the knees in seronegative spondyloarthropathies and skin psoriasis: magnetic resonance imaging case-control study. The Journal of rheumatology 2010; 37 (08) 1709-1717.
  • 19 Yasser R, Yasser E, Hanan D. et al. Enthesitis in seronegative spondyloarthropathies with special attention to the knee joint by MRI: a step forward toward understanding disease pathogenesis. Clinical rheumatology 2011; 30 (03) 313-322.
  • 20 Chen J, Liao M, Zhang H, Zhu D. Diagnostic accuracy of dual-energy CT and ultrasound in gouty arthritis: A systematic review. Zeitschrift fur Rheumatologie 2017; 76 (08) 723-729.
  • 21 Gamon E, Combe B, Barnetche T, Mouterde G. Diagnostic value of ultrasound in calcium pyrophosphate deposition disease: a systematic review and meta-analysis. RMD open 2015; 01 (01) e000118.
  • 22 Gunther F, Fleck M, Bach B. [Virus-associated arthritis]. Zeitschrift fur Rheumatologie 2017; 76 (08) 693-704.
  • 23 Herzer P, Fingerle V, Pfister HW, Krause A. [Lyme borreliosis]. Der Internist. 2014; 55 (07) 789-802 quiz 3–4.
  • 24 Michael JW, Schluter-Brust KU, Eysel P. The epidemiology, etiology, diagnosis, and treatment of osteoarthritis of the knee. Deutsches Arzteblatt international 2010; 107 (09) 152-162.
  • 25 Rossi R, Dettoni F, Bruzzone M. et al. Clinical examination of the knee: know your tools for diagnosis of knee injuries. Sports medicine, arthroscopy, rehabilitation, therapy & technology: SMARTT 2011; 03: 25.
  • 26 Knutson T, Bothwell J, Durbin R. Evaluation and management of traumatic knee injuries in the emergency department. Emergency medicine clinics of North America 2015; 33 (02) 345-362.
  • 27 Coakley G, Mathews C, Field M. et al. BSR & BHPR, BOA, RCGP and BSAC guidelines for management of the hot swollen joint in adults. Rheumatology 2006; 45 (08) 1039-1041.
  • 28 Trampuz A, Zimmerli W. Diagnosis and treatment of implant-associated septic arthritis and osteomyelitis. Current infectious disease reports 2008; 10 (05) 394-403.
  • 29 Charalambous CP, Tryfonidis M, Sadiq S. et al. Septic arthritis following intra-articular steroid injection of the knee – a survey of current practice regarding antiseptic technique used during intraarticular steroid injection of the knee. Clinical rheumatology 2003; 22 (06) 386-390.
  • 30 Klatte TO, Lehmann W, Rueger JM. [Primary meningococcal infection of the knee. A rare cause of septic arthritis]. Der Unfallchirurg 2015; 118 (10) 885-889.