My knee keeps filling with fluid and the MRI says synovitis. What does that mean?

Reading the MRI report

• Joint effusion: extra fluid in the knee, graded small, moderate or large
• Synovitis or synovial thickening: the lining is inflamed and thicker than normal
• Other findings matter just as much: meniscus tears, cartilage loss, bone marrow oedema, loose bodies or ligament injury

A small amount of fluid is a common finding, especially after activity, and is not always significant.

Why it keeps coming back

• A mechanical problem: a meniscus tear, unstable cartilage flap or loose body irritating the lining
• Osteoarthritis: wear particles cause repeated low-grade inflammation
• Crystal arthritis: gout or pseudogout flares
• Inflammatory arthritis: rheumatoid, psoriatic or reactive arthritis
• Overload: a sudden increase in walking, stairs or training
• Less common: pigmented villonodular synovitis, now called tenosynovial giant cell tumour, a benign overgrowth of the lining that often causes repeated, sometimes bloody, swelling

What you can do now

Reduce the activities that trigger swelling for a while, use ice after activity and keep the thigh muscles working with straight-leg exercises. Keep a note of when the swelling comes, whether other joints are affected, and any skin rash, eye or bowel symptoms. Draining the fluid gives short relief, but it often returns unless the cause is treated.

Getting answers in Doha

At Aman Hospital Dr. Gelber reviews your MRI images, not only the report, and examines the knee. When the cause is unclear, he may drain and test the fluid for crystals, cell count and infection, arrange blood tests, or involve a rheumatologist. Treatment then targets the driver, from physiotherapy and medication to arthroscopy when a mechanical problem or abnormal lining is found.