Hydrarthrosis, intermittent

Hydrarthrosis, intermittent

A rare rheumatologic disease characterized by recurrent self-remitting episodes of acute monoarticular arthritis, often with a fixed periodicity, typically affecting the knee or another large joint, which develops an effusion over 12 to 24 hours with only mild to moderate pain and minimal signs of inflammation. Attacks last three to five days and may parallel menses in females. Systemic symptoms are absent, and no joint damage occurs.


The following are the most common causes of Intermittent hydrarthrosis:

  • genetic mutation in MEFV gene (Mediterranean fever)
  • genetic mutation in TRAPS gene (Tumor Necrosis Factor Receptor Associated Periodic Syndrome)


  • Repeated, periodic joint effusions of the knee. Other joints may also be involved along with the knee. Onset of effusions are sudden with no particular trigger or stimulus. Each episode lasts for a few days to about a week and recurs in cycles of 7 to 11 days with extremes of 3 days to 30 days also reported
  • Stiffness
  • Tenderness of the joint may or may not be present
  • Aspirated synovial fluid is usually sterile but will sometimes show elevated cell count (>100 cells/mL) with 50% being polymorphonuclear leukocytes.
  • Sometimes the joint may begin to swell again as soon as the fluid has subsided. Where both knees are affected concurrently, as one joint ceases to swell the other may become involved.
  • In women, many cases seem to begin at puberty. Episodes of knee swelling may coincide with the menstrual cycle. 
  • Fever is rare

How to diagnose Intermittent hydrarthrosis?

There is no specific test for this condition. Diagnosis is based on signs and symptoms, and exclusion of other conditions.

This condition will be rated on limitation of motion of affected body part.

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