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Knee pain diagnosis

Old age, trauma injuries and physical activities are the major factors that result in knee pain. The complex design of knee joints and the importance it holds in bearing the weight of the body are the main reasons that make the knee joints vulnerable to injuries. The injury can affect bursae, ligaments or tendons that surround the knee joint as well as the menisci, cartilage and bones that form the joint.

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Fractures

Fracture to any of the three bones of knee can be serious and may need surgical repair and immobilization with casting or other support.

Ligament injury

Knee pain diagnosis due to ligament injury involves the following:

Trauma can inflict injury to the ligaments in the outer and inner portion of the knee or inside the knee. These injuries are noticed due to immediate pain, but it may be difficult to localize the point of pain in the knee.

As a matter of fact, collateral ligament injury is felt on the outer or inner portion of the knee and is often associated with tenderness over the area involved.

A cruciate ligament injury is located deep inside the knee, occasionally noticed with a ‘popping’ sensation with initial injury. Normally the ligament injury to the knee is swollen, painful and warm to touch. The pain increases when the knee is bent, while walking or while bearing weight on knee. The feelings of pain may vary from mild to severe. In a single traumatic event, the patient can have more than one part injured.

In initial stage, ligament injuries are treated with elevation, ice packs, rest and immobilization. It is advised to avoid putting weight on the injured knee joint. One may need crutches for walking, while some are placed in braces or splints to restrict the movement of joints, to reduce the pain and to improve healing. Severe knee injuries may require an open or arthroscopic surgery for effective repair and healing.

Surgical repair may include only suturing or synthetic graft repair and grafting. They can be carried out by either arthroscopic surgery or by open knee surgery, depending on the level of damage to the ligaments and the expected activities of the patient. With the current surgical techniques, the reconstruction procedures for cruciate ligaments are more successful.

Tendinitis

Knee pain diagnosis due to tendinitis involves the following:

Tendinitis is a type of tendon inflammation and often caused activities such as jumping that result in knee strain. Tendinitis is diagnosed as per the location of the tendon pain and tenderness. The condition may affect either the front part of knee, at the patellar tendon below the knee cap, or at the popliteal tendon in back side of knee.

It is treated with rest, ice packs, anti inflammatory drugs or use of a knee brace to immobilize it. The tissues in and around the tendon are reenergized by a gradual exercise plan. Corticosteroids are avoided for patellar tendinitis because of the risk of getting tendon rupture.

When tendon rupture occurs, below or above the knee cap, then it may cause bleeding within the knee joints and any knee movement can cause extreme pain. In this condition surgery become necessary to repair the ruptured tendon.

Meniscus tears

Knee pain diagnosis due to meniscus tears involves the following:

The meniscus may get torn by excess forces of rotation that are forced on the knee by rapid, jerky motions. Such movements are common in certain sports like badminton that require quick reactions of the legs. The incidence is higher with old age and deterioration of underlying cartilage. A single meniscus can have more than one tear. A subject with meniscal tear may experience rapid occurrence of popping sensation due to motion and other activities of the knee. It is often accompanied by warmth, swelling and uneven sensations in the knee joint.

As X-rays do not reveal the meniscal tear, it can be diagnosed by arthroscopy, MRI or by arthrography.

  • Arthroscopy is a surgical method, wherein a small video camera is inserted via tiny incisions on the sides of the affected knee. This facilitates the examination and repair of the knee joint problems and the torn meniscus.
  • MRI scan is another form of radiology technique, wherein a computer and magnetic fields combine to provide 2 or 3 dimensional pictures of the affected knee, thereby enabling physicians to get accurate information about the knee joints.
  • Arthrography is a radiology method wherein a contrast liquid is injected into the knee joint. This makes the internal structure visible in X-ray film.

Arthroscopic surgery is usually used to repair meniscal tears.

Knee pain due to the presence of diseases

Knee pain diagnosis due to the presence of certain health conditions involves the following:

Immune diseases and rheumatic diseases which affect the body tissues and joints, cause arthritis and knee pain

  • The inflammation of knee joints caused by arthritis, can either be non-inflammatory form of arthritis like osteoarthritis (degeneration of knee cartilage) or be inflammatory form of arthritis such as gout or rheumatoid arthritis.
  • The treatment is provided depending on the type of arthritis. Many suffer from severe arthritis with pain and discomfort and some may need a total replacement of knee joints.
  • Pain and swelling of the knee joints due to arthritis can cause localized collection of fluid in a Baker cyst behind the knee.

Tumors in knee joints: Tumors in joints are very rare.

  • It can cause severe pain and complications. Depending on the type of tumor the treatment is decided. Surgical intervention is normal, while some may need amputation.

Infection of the knee joints: In rare cases, infections of the joint or bone causes knee pain

  • Associated knee infection symptoms include fever and chills, temperature, warmth of joint and puncture wounds around the knee. Diagnosis of knee joint infections involves aspirating joint fluid collections by a needle and examining it with microbial culture techniques. It is treated with antibiotics and occasionally with surgery.

Other diseases of the knee:

  • Osgood-Schlatter disease is caused by chronic inflammation of tendon area present below the knee cap where it connects to tibia bone. It can cause tenderness and local pain. Treatment includes controlling inflammation and Restriction of activities. In children, it is a common cause of pain in front part of knee.
  • Calcification of the collateral ligament inside the knee joint is referred as Pellegrini-stieda syndrome. Under this condition, the knee can get inflamed which can be given conservative treatment with immobilization, ice packs, rest and corticosteroid injection when required.
  • Bursitis of knee normally occurs in the front of kneecap and inside the knee. Anti-inflammatory medications, ice packs, rest, corticosteroid injections, exercise therapy are the standard treatments.
  • Chondromalacia is softening of cartilage under the knee cap. It is the common cause for stiffness and deep knee pain in young women. The pain and stiffness is the manifestation of climbing stairs, prolonged sitting or hiking. Anti-inflammatory drugs, rest and ice packs provide relief. Exercises for strengthening quadriceps muscles can provide long term benefits
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