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Knee Pain Overview (cont.)

Knee Pain Diagnosis

  • History: Even in today's world of technology, physicians rely on a detailed history and examination more than any single test.
    • The doctor will typically want to know the exact nature of the pain.
      • Where in the knee is your pain?
      • What does the pain feel like?
      • Has it happened before?
      • What makes it better or worse?
      • How long have you had pain in the knee?
    • The doctor will also want to know a bit about you.
      • Do you have any major medical problems?
      • How active is your lifestyle?
      • What are the names of the medications you are taking?
    • The doctor will want to know about any related symptoms.
      • Do you still have normal sensation in your foot and lower leg?
      • Have you been having fevers?
  • Physical examination
    • The doctor will likely have you disrobe to completely expose the knee.
    • The doctor will then inspect the knee and press around the knee to see exactly where it is tender.
    • In addition, the doctor may perform a number of maneuvers to stress the ligaments, tendons, and menisci of the knee and evaluate the integrity of each of these. An experienced health care professional will be able to make a preliminary diagnosis based on this examination.
    • These maneuvers can establish potential tendon, ligament, or meniscus injuries.
  • X-rays
  • and CT scans
    • Depending on your particular history and examination, the doctor may suggest X-rays of the knee. X-rays show fractures (broken bones) and dislocations of bones in the knee as well as arthritic changes and abnormally large or small joint spaces.
    • Rarely, the doctor may order a CT scan
    • (a three-dimensional X-ray) of the knee to precisely define a fracture or deformity.
    • Both X-rays and CT scans are excellent for diagnosing fractures. They both are also poor, however, at evaluating soft-tissue structures of the knee such as ligaments, tendons, and the menisci.
  • MRI
    • Magnetic resonance imaging
    • (MRI) uses large magnets to create a three-dimensional image of the knee.
    • In contrast to CT scans, MRIs do not image bones and fractures well.
    • Also in contrast to CT scans, MRIs are excellent for evaluating ligaments and tendons for injuries.
  • Fluid removal
    • The knee and all bursae of the knee are filled with fluid.
    • If your symptoms suggest infection, inflammation, or certain types of arthritis
    • , your physician may use a needle to remove fluid from the knee.
    • The removal of the fluid will sometimes decrease the pain you have been experiencing and make it possible for you to bend your knee.
    • This fluid will then be analyzed to better clarify the diagnosis and detect infection.
    • Crystals, which suggest crystalline arthritis, often can be seen under the microscope.
  • Blood tests: The doctor may also elect to perform certain blood tests to evaluate for signs of infection or diseases such as rheumatoid arthritis
  • and diabetes.
  • Arthroscopy
    • The orthopedic surgeon may elect to perform arthroscopy if you have chronic knee pain.
    • This is a surgical procedure where the doctor will place a fiberoptic camera within the knee joint itself.
    • By doing so, the surgeon may be able to see small particles in the knee or to look more closely at damaged menisci or cartilage.
    • The doctor may also be able to repair damage by shaving down torn cartilage or removing particles from the knee while the camera shows the inside of your knee.
Medically Reviewed by a Doctor on 2/19/2016

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Knee Injury, Soft Tissue »

Soft tissue injuries of the knee are some of the most common and clinically challenging musculoskeletal disorders in patients presenting to the ED.

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