Electrolyte Imbalance

The human body is composed of up to 60 % water. Adequate fluid and electrolyte levels are essential for healthy functioning of all organs and body systems. Electrolytes are found in the blood, urine, tissues and body fluids. Sodium, calcium, potassium, chlorine, phosphate and magnesium play an important role conducting electric charge within the body. These minerals must be maintained in the appropriate ratio for proper functioning of the muscles, nerves, brain and heart. If there is any imbalance in their ratio, which usually occurs due to change in water levels in the body, electrolyte imbalance will occur. The kidneys work as major regulators of the electrolyte balance. Kidney malfunction results in excessive electrolyte retention or excretion resulting in an imbalance.

Symptoms of electrolyte imbalance vary with the electrolyte. Typical symptoms of electrolyte imbalance include fatigue, dizziness, excessive sweating, cold extremities and trembling. Swelling in the feet, ankles, legs, and hands might also be due to a fluid and electrolyte imbalance. There might be nausea, reduced urine output, dark urine, dry skin, aching joints and dry mouth. In cases of severe electrolyte imbalance, there might be convulsions and seizures.

Urine test and blood tests are done to evaluate the electrolyte imbalance. Often kidney ultrasound or EKG might be ordered. Based on the electrolyte that is out of balance, treatment includes dietary changes, fluid intake restrictions and medications to correct the imbalance. Often medication like corticosteroids, laxatives, cough medicines, diuretics and oral contraceptives can cause changes in the electrolyte balance.

Hyponatremia: Imbalance in sodium concentration in the plasma.

Hypokalemiaa: Deficiency of potassium in the bloodstream.

Hypercalcemia: Elevated calcium level in the blood.

Dehydration

Water forms a large part of our bodies and plays no small role in vital functions such as eliminating waste, transporting and absorbing nutrients and formation of body fluids. Dehydration occurs when a body loses more fluids than normal and the body faces shortage of water for normal functioning. While this condition can happen at any age, it can be very dangerous in babies and young children. Untreated severe dehydration can lead to seizures, permanent brain damage or death.

1. Gastrointestinal illness leading to diarrhea and vomiting can lead to dehydration. If a person does not replenish the water levels in the body with timely fluids, tremendous loss of water and electrolytes in a short amount of time is noticed. This can be life threatening in small babies and older persons.

2. Athletes, wrestlers and those engaging in sports may sweat and lose body water. Saunas and steam baths also have a dehydrating effect on the body. It can lead to electrolyte imbalance.

3. Fad diets, laxatives and diuretics can lead to dehydration.

4. Going out on a warm day and excessive sweating can cause the body to become dehydrated.

5. Aerated drinks, tea and coffee add to dehydrating effect

6. A person who is ill and running fever is more likely to become dehydrated.

Some of the symptoms of dehydration are dizziness and dry or sticky mouth. The dehydrated person produces less urine of a darker color. Low blood pressure and poor skin turgor are noticed. Dehydration can lead to dizziness and listlessness. In an infant it is imperative to recognize the symptoms of dehydration. The infant may become lethargic and have a marked sunken fontanelle (soft spot on the top of the head). The child may pass blood in the stools.

Drinking plenty of water and electrolytes can help in tackling dehydration. For severe cases of dehydration, intravenous fluids and hospitalization will be needed.

Synovial fluid and Synovial gas

Synovial fluid and Synovial gas are two important components related to joint health and function.

Synovial Fluid :
Synovial fluid is a thick, transparent liquid found in the cavities of synovial joints, such as the knee, hip, or shoulder joints. It acts as a lubricant and shock absorber for the joint. The synovial fluid is secreted by the synovial membrane, which lines the joint capsule.

Functions of Synovial Fluid :

Lubrication: Synovial fluid reduces friction between the joint surfaces during movement, allowing smooth and pain-free motion. Nutrient Supply: It delivers oxygen, nutrients, and other essential substances to the articular cartilage, which lacks its own blood supply.
Waste Removal: Synovial fluid helps remove metabolic waste products from the joint, maintaining a healthy environment.

Composition of Synovial Fluid :

Synovial fluid consists of water, hyaluronic acid, lubricin, proteins (such as albumin and globulin), glucose, electrolytes, and cells (mainly synovial fibroblasts and white blood cells). The composition may vary in different joint diseases or conditions.

Clinical Significance:

Examination of synovial fluid (through arthrocentesis) can help diagnose joint disorders like arthritis, infection, or crystal-related conditions. Changes in synovial fluid analysis, such as increased white blood cell count or presence of bacteria, may indicate joint inflammation or infection.

Synovial Gas :

Synovial gas refers to the presence of gas bubbles or pockets within the synovial fluid of a joint. It primarily consists of nitrogen and, to a lesser extent, carbon dioxide and oxygen. This gas is dissolved in the synovial fluid under normal conditions.

Formation of Synovial Gas: :

The exact mechanism of gas bubble formation within the synovial fluid is not fully understood. However, it is believed that gas can accumulate due to a decrease in joint pressure, rapid joint movement, or sudden changes in joint position.

Pop Sound during Joint Flexion :

When you flex or move a joint, such as bending your fingers or cracking your knuckles, the joint capsule expands. This expansion causes a sudden decrease in joint pressure, leading to the formation of gas bubbles within the synovial fluid. The rapid release or collapse of these bubbles creates a popping or cracking sound.

Functions of Gas in Joints:
Joint Stability: The gas helps maintain joint stability by balancing intra-articular pressures during movement. Nutrient Exchange: The gas allows for the exchange of gases and nutrients between the synovial fluid and the articular cartilage.

Clinical Significance:
Excessive gas accumulation within the joint may cause joint distension, discomfort, or pain. This can occur in conditions such as joint effusion or intra-articular fractures.

It's important to note that cracking your joints does not lead to long-term joint damage or arthritis, contrary to popular belief. However, intentionally cracking your joints excessively or forcefully may increase the risk of injury.
Understanding the phenomenon of synovial gas and the associated pop sound can help medical professionals differentiate between normal joint sounds and potentially problematic ones. If patients have concerns or experience persistent symptoms related to joint cracking, a thorough clinical examination and appropriate investigations can help determine the underlying cause.