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Our three-year old grandson is in the ER right now for a badly swollen knee they think is some kind of infection. They are talking about draining the fluid right away. We hate to see him poked and prodded. Can't they just use antibiotics for something like this?

Antibiotics are the main treatment for any kind of joint infection. But there is always a concern for the kind of cartilage destruction that can occur with an overactive immune system. And excess swelling, warmth, redness, and tenderness to touch are all signs of that inflammatory process. It's also the case that a delay in diagnosis and/or treatment can result in the condition getting worse with the potential for permanent joint damage. That's why physicians often advise a procedure called needle aspiration. A numbing agent is rubbed on the skin so the child does not feel the injection. General anesthesia may also be used so the child is asleep when the procedure is done. A long thin needle is then placed inside the joint and the fluid removed. The child's comfort is always a number one priority. Removing the fluid will also reduce the pressure inside the joint and bring immediate pain relief. Sometimes the joint fills up with fluid again and the procedure has to be repeated. If there's no change in symptoms and the fluid accumulates again after two aspirations, then surgical drainage is the next step. The surgeon not only drains the joint, the area is also irrigated (flushed out) to clear away any bacteria causing the inflammatory reaction. The goal of treatment is to reduce pain and other symptoms but also restore the child's full joint motion. The hope is to do so without any residual joint damage, destruction, or deformity.

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