EpistemisMechanical joint block
Specialty: Musculoskeletal.
Why it occurs
- Presence of intra-articular loose bodies (detached cartilage fragments or osteophytes, joint mice)
- Meniscus tear in bucket handle (classic knee joint lock)
- Patellar dislocation or subluxation of incomplete return
- Injuries to the articular labrum (hip or shoulder)
- Villous pigmented nodular synovitis or synovial chondromatosis
- Post-surgical intra-articular fibrous adhesions (arthrofibrosis)
Initial workup
Plain x-ray in adequate projections of the affected joint | Magnetic resonance imaging of the joint (method of choice to identify meniscal, labral and loose body injuries) | Diagnostic/therapeutic arthroscopy in selected cases.
red flags
Acute joint blockage associated with massive inflammation of rapid onset, pallor or distal coldness of the extremity with absence of pulses (indicates neurovascular compromise secondary to severe dislocation or entrapment, requires emergency reduction).
Standard management
- Dexketoprofen — 25 mg every 8 hours orally; rapid analgesic for the control of acute blockage pain
- Tramadol — 50 mg orally every 8-12 hours depending on pain intensity
- Methylprednisolone (40 mg intramuscularly to control presurgical reactive synovial edema).
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- Musculoskeletal
- Listed causes
- 6
- Treatment options
- 3