Run-off is a physical exam technique to check for fluid buildup, commonly used in knee exams. Needle aspiration biopsies can provide important information about the nature of fluid accumulations found during the runoff. Treatment depends on the cause, including medication and draining.
Run-off is a physical exam technique used by a healthcare provider to check for fluid buildup. It is most commonly employed in an examination of the knee, but can also be used in the evaluation of other joints and the abdomen. Large deposits of fluid can be a cause for concern, as they can indicate an ongoing inflammatory process. If the test shows the presence of fluid, your health care provider may ask you to perform a needle aspiration biopsy, in which a fine needle is inserted into the area and used to take a sample of fluid for evaluation.
In the case of a knee exam, the health care provider performs the runoff by gently pushing down on the kneecap. It should move freely, without jerks or sluggishness. If the kneecap doesn’t move smoothly, or bounces after the exam, this may be a sign that fluid is present in the joint. The fluid may be visible or palpable in some cases, depending on the nature of the swelling. Similar palpation tests can provide information about fluid accumulations in other areas of the body.
This test allows the healthcare provider to determine if the structure of interest appears to be floating, rather than articulating with nearby structures. This may indicate that fluid is causing swelling and separation. In knee runoff, for example, the kneecap may feel slightly swampy on examination, suggesting that it is pushing through fluid. The pressure within the joint can also be so intense that it is difficult to push the kneecap.
Needle aspiration biopsies can provide important information about the nature of fluid accumulations found during the runoff. They can reveal the presence of a large number of white blood cells, indicative of infection. Abnormal cells or organisms in the sample can also be signs of disease. Some doctors can quickly review the sample in the office to gather immediate information about the situation. Others may prefer to send it to a pathologist for a qualified evaluation.
Immediate treatment for swellings may depend on the cause. Heavy pressure found during runoff may require drains to be placed to allow fluid to escape. Medications can reduce inflammation and swelling, as can the application of ice and cold packs. Emergency measures such as resting and freezing an inflamed knee may be recommended to control swelling until the doctor can figure out the cause, at which point more permanent treatment can be provided.
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