Joint swelling is a common feature of joint disease and the examination of a swollen joint should be directed at descriminating the three types of joint swelling:
The former may be identified by straight forward palpation and bony swelling may occur due to osteophytes or heterotopic calcification. If the swelling however is soft, the presence of fluctuation suggests the presence of an effusion which may be further supported by the presence of a patellar tap at the knee or by direct aspiration of the joint. A non-fluctuant firm dwelling is characteristic of synovial thickening.
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