MANUAL MINORS
An elbow effusion without visible fracture refers to the accumulation of fluid in the elbow joint cavity, typically resulting from soft tissue injury or an inflammatory process. It is often detected by swelling and tenderness around the joint, with no fracture evident on conventional X-rays.
Diagnosis
Diagnosis is primarily clinical, identifying signs such as pain, swelling, and limited mobility. Ultrasound may be useful for confirming the presence of fluid in the joint, and X-rays are used to rule out fractures, although these may not always be visible initially. In some cases, MRI is performed to assess soft tissue injuries like tendons, ligaments, or cartilage.
Differential Diagnosis
Condition | Characteristics |
|---|---|
Occult fracture | Not visible on initial X-rays; may require CT or MRI for detection. |
Lateral epicondylitis | Localised pain on the outer elbow, without joint effusion. |
Septic arthritis | Severe pain, fever, and warmth in the joint; requires fluid analysis. |
Olecranon bursitis | Localised inflammation in the olecranon bursa, without joint involvement. |
Synovitis | Inflammation of the synovial membrane, usually without a history of major trauma. |
Emergency Management
Initial emergency management includes immobilising the elbow to reduce pain and prevent movement, administering analgesics and non-steroidal anti-inflammatory drugs (NSAIDs), and applying ice to reduce inflammation. If a more severe injury is suspected, an MRI or CT scan may be ordered. In cases of significant effusion, arthrocentesis (joint fluid drainage) may be performed to relieve symptoms and analyse the fluid if infection is suspected.
Definitive Treatment
Definitive treatment depends on the underlying cause of the effusion. For minor injuries, rest and physiotherapy may suffice. In more severe cases, such as ligament or tendon injuries, surgical intervention may be required.
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