Why Is One Knee Swollen But Not the Other?

A Doctor’s Guide to Sudden, Unilateral Knee Swelling
You wake up.
You swing your legs out of bed.
And then — it hits you.
Your right knee is puffy, red, and hot.
It feels tight — like a balloon about to burst.
The left? Perfectly fine.
No fall.
No twist.
No memory of injury.
Just one knee… screaming.
This isn’t “just swelling.”
It’s your body’s emergency alert system — and it’s going off in only one joint for a reason.
While bilateral knee swelling (both knees) often points to systemic conditions like rheumatoid arthritis or lupus, swelling in just one knee is a localized crisis — a problem confined to that joint.
And as an orthopedic specialist who’s evaluated over 5,000 knee cases, I can tell you: