Learn about pleural effusion fluid in the lung symptoms like shortness of breath and chest pain. Both are discussed, as is the rationale behind the current management of this unusual condition. Pericardial effusion can develop in patients with virtually any condition that affects the pericardium, including acute pericarditis and a variety of systemic disorders. Joint effusion on examination joint effusion present. A hemorrhagic effusion contains blood in the fluid.
Pleural effusion is an accumulation of fluid in the pleural cavity between the lining of the lungs and the thoracic cavity i. A pleural effusion is an abnormal collection of fluid in the pleural space resulting from excess fluid production or decreased absorption or both. Our results suggest that a more comprehensive grading system might be advantageous in helping triage and treat patients with svc syndrome. Successful aspiration of a pleural effusion may be performed at a level above the radiographic shadow of fluid.
Bausili mm, raja h, kotowski j, nadal j, salomao dr, keenum d et al. Effusions may be classified as a pure transudate, a modified transudate, an exudate, a hemorrhagic effusion, or a neoplastic effusion. Two separate hypotheses have been postulated to explain the pathogenesis of the uveal effusion syndrome, one relating to abnormally thickened sclera, the other to chronic bulbar hypotony. Three patients with bilateral ues were treated with the same. An imbalance of fluid formation and drainage a pleural effusion an excessive accumulation of fluid in the pleural spaceindicates an. Uveal effusion syndrome is a rare disease which belongs to the differential diagnosis of choroidal tumour with serous retinal detachment. Serous effusion systemic local disease common cirrhosis frequently reactive any type of tumor may cause malignant effusion serous effusion transudates exudates chylous chf infections trauma collagen vascular disease malignancies nephrotic syndrome embolism infarction malnutrition uremia vena cava obst. It is hypothesized that the primary underlying cause of the idiopathic uveal effusion syndrome is a congenital anomaly of the sclera, and in some cases, the vortex veins. Doctors use the terms transudative and exudative to describe the two main types of pleural effusion.
Superimposed aging and hormonal changes in the sclera and its emissary channels impair its permeability to protein and predispose the eye to vortex vein obstruction. Uveal effusion syndrome is a rare, ocular disorder that typically affects middleage men, and is characterized by idiopathic serous detachment of choroid, ciliary body, and retina. Uveal effusion syndrome e inflammatory conditions of choroid and sclera. For example, a pleural effusion is an abnormal accumulation of fluid in the pleural space between the lungs and the chest wall, while a knee effusion is an abnormal amount of fluid in the knee joint. In 1983, jmd gass hypothesized that the primary underlying cause of the idiopathic uveal effusion syndrome is a congenital anomaly of the sclera, and in some cases, the vortex veins. Raskin, dvm, phd, diplomate acvp professor of veterinary clinical pathology dept of veterinary pathobiology purdue.
There is normally only a small amount of physiological intraarticular fluid. Hansen lecture carol l shields, kelsey roelofs, maura di nicola, kareem sioufi, arman mashayekhi, jerry a shields purpose. Use of fiberopticguided co2 laser in the treatment of. The modern diagnosis and management of pleural effusions. The purpose of the study was to investigate the corticosteroids for uveal effusion syndrome ues. In an upright xray, 75 ml of fluid blunts the posterior costophrenic angle. Scleral hydraulic conductivity and macromolecular diffusion in. Causes a subdural effusion is a rare complication of meningitis caused by bacteria. Choroidal findings in idiopathic uveal effusion syndrome. Knee effusions may be the result of trauma, overuse or systemic disease.
However, the knee joint is susceptible to effusions secondary to a wide variety of atraumatic causes. Mechanism of abnormal pleural fluid formation increasedhydrostaticpressurechfincreased hydrostatic pressure chf. Arthrogenic muscle inhibition that manifests with muscle weakness has been reported in many patients as a result of joint effusion 9, most commonly affecting the quadriceps muscle. Chest xray is the first test done to confirm the presence of pleural fluid. To report a case series of three patients with bilateral uveal effusion syndrome ues, treated conservatively with oral carbonic anhydrase inhibitors and topical prostaglandin analogues pas. It is characterized by annular ciliochoroidal detachment, shifting nonrhegmatogenous retinal detachment, unremarkable inflammation in the anterior eye segment and normal intraocular pressure. Blunting of the lateral costophrenic angle usually requires about 175 ml but may take as much as 500 ml. Septic arthritis is the purulent invasion of a joint by an infectious agent with a resultant large effusion due to inflammation gout. Uveal effusion syndrome ues is a rare condition affecting hyperopic eyes that can lead to suprachoroidal fluid accumulation and subsequent choroidal and retinal detachments. The correct diagnosis is important as sclerectomy or sclerotomy may be an effective treatment. The number of atomic or molecular collisions with a wall of a container per unit area per unit time impingement rate is given by. It may result from trauma, inflammation, hematologic conditions, or infections. Uveal effusion syndrome is a rare entity involving the idiopathic collection of serous fluid in the suprachoroidal space. It is most commonly caused by infection, injury, and arthritis.
Exudates may be subdivided into septic or nonseptic exudates. Fullthickness sclerotomy for uveal effusion syndrome. Joint effusion is a pretty serious condition that can be caused by a number of different things. Joint effusion, commonly referred to as water on the knee or fluid on the knee, is the abnormal accumulation of fluid in or around a joint. There are various inflammatory and hydrostatic conditions that can cause uveal effusion, but in some cases no obvious cause exists.
Effusions definition of effusions by medical dictionary. Uveal effusion syndrome american journal of case reports. Spontaneous exudative detachment of the choroid and ciliary body was first reported by schepens and brockhurst in 1963 1. Use of fiberopticguided co 2 laser in the treatment of uveal effusion.
Idiopathic uveal effusion syndrome is a rare acquired eye disease characterized by uni or bilateral abnormal fluid accumulation within the suprachoroidal space. Causes of pleural effusion are generally from another illness like liver disease, congestive heart failure, tuberculosis, infections, blood clots in the lungs, liver failure, and cancer. Effusion from an equilibrated container into outside vacuum can be calculated based on kinetic theory. The onset is spontaneous and the progression of the disease is slow, often leading to bilateral serous choroidal detachment and concomitant retinal detachment, shifting subretinal fluid and, in severe cases, total loss of visual acuity. Choroidal findings in idiopathic uveal effusion syndrome tomomi harada, shigeki machida, takamistu fujiwara, yasunori nishida, dajiro kurosakadepartment of ophthalmology, iwate medical university school of medicine, iwate, japanpurpose. The surgical management of uveal effusion syndrome article pdf available in eye 1 pt 11.
Subdural effusion penn state hershey medical center. Pleural effusions are common, with an estimated 11. Jackson tl, hussain a, morley ams, sullivan pm, hodgetts a, elosta a, et al. The pleural fluid is called a transudate if it permeates transudes into the pleural cavity through the walls of intact pulmonary vessels. A subdural effusion is a collection of cerebrospinal fluid csf trapped between the surface of the brain and the outer lining of the brain the dura matter. Uveal effusion syndrome is a rare syndrome of idiopathic exudative detachments of choroid, ciliary body and retina, thought to arise from. Uveal effusion syndrome an overview sciencedirect topics. Such a grading system should be validated in a larger cohort of patients.
A pericardial effusion is considered to be present when accumulated fluid within the sac exceeds the small amount that is normally present. Retina today management of uveal effusion syndrome. Moreover, gait disturbances due to effusion in the knee joint has also been reported as a. An understanding of knee pathoanatomy is an invaluable part of making the correct diagnosis and formulating a treatment plan. Medical treatment and conventional vitreoretinal surgery are ineffective in treating the uveal effusion seen in idiopathic uveal effusion syndrome and nanophthalmos. Uveal effusion syndrome is a rare syndrome of idiopathic exudative detachments of choroid, ciliary body and retina, thought to arise from impaired posterior segment drainage usually associated with scleral thickening.
Uveal effusion syndrome usually causes peripheral chorioretinal. Accumulated fluid from a pericardial effusion evacuated by the. Idiopathic uveal effusion syndrome ues is an extremely rare disease characterized by suprachoroidal fluid collections and serous retinal detachment rd. This case highlights the treatment and management options for ues. Links to pubmed are also available for selected references. It was characterized by the accumulation of fluid escaped from the choriocapillaries into nearby free space, resulting from compressed vortex. Pdf the surgical management of uveal effusion syndrome. The lateral upright chest xray should be examined when a pleural effusion is suspected.
Uveal effusion syndrome was described for the first time in 1963 by rj brockhurst. Purposeto report a case series of three patients with bilateral uveal effusion syndrome ues, treated conservatively with oral carbonic anhydrase inhibitors and topical prostaglandin analogues. Scleral hydraulic conductivity and macromolecular diffusion in patients with uveal effusion syndrome. The presence of an intraarticular knee effusion requires an extensive differential diagnosis and a systematic diagnostic approach. The pathogenetic mechanism behind the development of the uveal effusion syndrome is believed to be a thickened sclera resulting from the accumulation of. Almost two decades later, gass and jallow in 1982 coined the term idiopathic uveal effusion syndrome to describe idiopathic serous detachment of the. A 70yearold man was admitted to hospital because of retinal. Get a printable copy pdf file of the complete article 2. Gout is usually present with recurrent attacks of acute inflammatory arthritis red, tender, hot, swollen joint. Uveal effusion syndrome ues is a rare idiopathic cause of choroidal detachment that may be associated with nanophthalmos and increased scleral thickness. Uveal effusion, also referred to as choroidal detachment, can occur secondary to a number of ocular conditions that result in inflammatory or hydrostatic changes, including scleritis, posterior uveitis, and hypotony after glaucoma surgery. If the pleural ph is used to assess the prognosis of a parapneumonic effusion, it must be measured with a blood gas machine.
In addition to swelling, joint effusion is associated with pain and stiffness. In up to 20% of cases the cause remains unknown despite a diagnostic workup. Fullthickness sclerotomy for uveal effusion syndrome ncbi. Pediatric knee effusions occur most commonly as acute hemarthroses after traumatic injury. The key thing to take away from this is that you need to be protecting your joints. Uveal effusion syndrome is a rare disease that largely affects middleaged male subjects. Especially if you do anything strenuous for work or hobbies such as gardening or sports.
We report choroidal findings by means of enhanced depth imaging spectraldomain optical coherence tomography edi. It is the most common manifestation of pleural disease, with etiologies ranging from cardiopulmonary disorders to symptomatic inflammatory or malignant diseases requiring urgent evaluation and trea. Full text full text is available as a scanned copy of the original print version. A joint effusion is defined as an increased amount of fluid within the synovial compartment of a joint.
A pleural effusion describes an excess of fluid in the pleural cavity, usually resulting from an imbalance in the normal rate of pleural fluid production or absorption, or both. Splenomegaly, hypersplenism, and hereditary disorders with. In this setting, patients are thought to have a distinct, primary abnormality of the choroid or sclera, called uveal effusion syndrome ues. It is called an exudate if it escapes exudes into the pleural cavity through lesions in.