Knee pain/swelling
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
The most common reasons of knee pain can include;
Differential diagnosis of knee pain/swelling
Common causes
Acute knee pain
- Ligament injuries
- Tendon injuries (tendinitis)
- Meniscus injuries
- Loose body
- Dislocated kneecap
- Osgood-Schlatter disease
- Iliotibial band syndrome
- Hyperextended knee
- Septic arthritis
Chronic knee pain
- Rheumatoid arthritis
- Osteoarthritis
- Gout
- Chondromalacia of the patella, or patellofemoral pain
Complete differential diagnosis of causes of knee pain/sweling
- Acute gouty arthritis
- Adult Still's Disease
- Anterior cruciate ligament (ACL) injury
- Baker's cyst
- Bone, ligament or cartilage damage
- Bursitis
- Chondromalacia patellae
- Chronic gouty arthritis
- Discoid meniscus
- Gonococcemia
- Hip or foot/ankle disease with referred pain to the knee
- Iliotibial Band Syndrome
- Joint effusion
- Joint infection
- Lateral collateral ligament (LCL) injury
- Malignancy
- Medial collateral ligament (MCL) injury
- Meniscus tear
- Osgood-Schlatter Disease
- Osteoarthritis
- Osteochondritis Dissecans (OCD)
- Osteomyelitis
- Osteosarcoma
- Patellofemoral syndrome
- Pes anserine bursitis
- Posterior cruciate ligament (PCL) injury
- Pseudogout
- Psoriatic arthritis
- Reiter's Syndrome
- Rheumatoid Arthritis
- Scleroderma
- Systemic Lupus Erythematosus
Diagnosis
History and Symptoms
- Gait abnormalities
- Swelling
- Erythema
- Deformity
- Muscle atrophy
Physical Examination
- Range of motion
- Palpate area of concern
- "Milk the joint"
- McMurray circumduction test
- Ligament testing
Laboratory Findings
- Complete blood count
- C-reactive protein
- Uric acid
- Alkaline phosphatase
- Erythrocyte sedimentation rate (ESR)
X-Ray
- Anteroposterior, lateral and merchant (or sunrise) films of both knees
- Tunnel views of knee
- Merchant and sunrise of the patella
MRI and CT
- MRI for confirmation of suspected diagnosis
Other Diagnostic Studies
- Bone scan
- Joint aspiration
Treatment
- Conservative therapy is best
- Lifestyle changes
- Physical therapy
- Exercise
Pharmacotherapy
Acute Pharmacotherapies
- Anti-inflammatory medications
- Joint medications
- Antibiotics
Surgery and Device Based Therapy
- Surgery necessary for most ACL injuries
- Meniscal tears may require surgical repair
- Joint infection requires surgery (emergency)
- Surgery may be necessary for osteoarthritis, if conservative treatment fails
References
Acknowledgements
The content on this page was first contributed by C. Michael Gibson, M.S., M.D.
List of contributors: