This result is highly statistically significant (p<ĭiscussion: It is well recognised that neoplastic or inflammatory conditions of the superficial tissues of the lower limb may be associated with inguinal lymphadenopathy. In the patients with superficial infection 32 (63%) had palpable inguinal lymphadenopathy while no patient with septic arthritis of the knee had palpably enlarged inguinal lymph nodes.

All were treated with antibiotics while eight of the bursitis group required incision and drainage. In the superficial infection group 28 (56%) had pre-patellar bursitis and 23 (54%) cellulites. All were treated with arthroscopic washout (average 2.2/patient) and antibiotic chemotherapy. Six patients had rheumatoid arthritis and two were HIV positive IVDA’s but the rest had no pre-disposing factors. The remaining seven patients had no growth but purulent fluid on aspirate with leukocyte counts in excess of 50,000/mm 3. Results: Joint aspirates from the group with septic arthritis grew organisms in twenty patients (staph aureus in 19, strep pneumoniae in one). The presence or absence of palpable inguinal lymph nodes was determined and compared for each diagnostic group. The former were diagnosed on the basis of clinical findings and a knee aspirate, the latter on clinical findings and response to treatment. Patients and Methods: From January 1995 until June 2000, twenty-seven patients were admitted with septic arthritis of the knee and fifty-one with superficial cellulites or bursitis about the knee. We reviewed the clinical findings in a group of patients with superficial or deep infections to test this theory. We hypothesise that the differences in lymphatic drainage mean that palpable inguinal nodes are more likely with superficial infections than with septic arthritis. Efferents from this node ascend in close relation to the femoral vessels and drains to the deep inguinal nodes. Drainage from the knee joint is to a popliteal node situated between the knee joint capsule and the popliteal artery. The lymph drainage of the superficial tissues of the lower limb is via lymphatics that accompany the long saphenous vein and drain to the lower group of the superficial inguinal nodes. The potential sequalae from aspirating a knee through infected superficial tissues further emphasise the importance of making an accurate clinical diagnosis. While superficial cellulites and bursitis are the most common diagnoses, anxiety is induced by the spectre of septic arthritis. Introduction: The red, hot swollen knee is commonly seen in the A&Į department and can present a diagnostic dilemma for the casualty officer.

Lymph fluid in knee