Knee Pain is a topic covered in the 5-Minute Clinical Consult.

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Basics

Description

A common outpatient complaint with a broad differential

  • Knee pain may be acute, chronic, or an acute exacerbation of a chronic condition.
  • Trauma, overuse, and degenerative change are frequent causes.
  • A detailed history, including patient age, pain onset and location, mechanism of injury, and associated symptoms can help narrow the differential diagnosis.
  • A thorough and focused examination of the knee (as well as the back, hips, and ankles) helps to establish the correct diagnosis and appropriate treatment.

Epidemiology

Incidence
  • Knee complaints account for 12.5 million primary care visits annually.
  • The incidence of knee osteoarthritis (OA) is 240 cases/100,000 person-years.

Prevalence
  • The knee is a common site of lower extremity injury.
    • Patellar tendinopathy and patellofemoral syndrome are the most common causes of knee pain in runners (1).
  • OA of the hip/knee is 11th cause of global disability and 38th most common cause of disability-adjusted life years (DALYS).

Etiology and Pathophysiology

  • Trauma (ligament or meniscal injury, fracture, dislocation)
  • Overuse (tendinopathy, patellofemoral syndrome, bursitis, apophysitis)
  • Age (arthritis, degenerative conditions in older patients; apophysitis in younger patients)
  • Rheumatologic (rheumatoid arthritis [RA], gout, pseudogout)
  • Infectious (bacterial, postviral, Lyme disease)
  • Referred pain (hip, back)
  • Vascular: popliteal artery aneurysm, deep vein thrombosis
  • Others: tumor, cyst, plica

Risk Factors

  • Obesity
  • Malalignment
  • Poor flexibility, muscle imbalance, or weakness
  • Rapid increases in training frequency and intensity
  • Improper footwear, training surfaces, technique
  • Activities that involve cutting, jumping, pivoting, deceleration, kneeling
  • Previous injuries

General Prevention

  • Maintain normal body mass index.
  • Proper exercise technique, volume, and equipment; avoid overtraining.
  • Correct postural strength and flexibility imbalances.

Commonly Associated Conditions

  • Fracture, contusion
  • Effusion, hemarthrosis
  • Patellar dislocation/subluxation
  • Meniscal or ligamentous injury
  • Tendinopathy, bursitis
  • Osteochondral injury
  • OA, septic arthritis
  • Muscle strain

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Citation

* When formatting your citation, note that all book, journal, and database titles should be italicized* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Knee Pain ID - 116899 ED - Baldor,Robert A, ED - Domino,Frank J, ED - Golding,Jeremy, ED - Stephens,Mark B, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116899/all/Knee_Pain PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -