Knee pain

 

Many painful conditions of the knee can be diagnosed with careful attention to the story and a careful examination. Knee pain can be very specific - related to a single structure where the pain may be very focal, or it may be vague and all that the patient can say is that it is 'in the front'. Pain may arise from the structures within the knee, or may be related to structures further away, such as the hip or lower back. It may be brought on my activities or experienced at rest.

What causes pain in the front of the knee?

Pain experienced in the front of the knee is referred to as 'anterior knee pain', but this is just a descriptive term and not a diagnosis. Pain in this area is often related to -

• damage to the fat pad
• an irritated synovial plica
• irritation of the patellar tendon under the kneecap
• damage to the joint cartilage under the kneecap

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What causes pain behind the knee?

Pain experienced at the back of the knee is commonly a Baker's cyst, but may also be related to one of the tendons in the area.

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What does arthritis pain feel like?

Arthritic pain is usually diffuse and comes on gradually, associated with stiffness and swelling of the joint. Pain is common at night and is often pulsing in character. Weather may affect the joint.

Arthritis of the knee is commonly the result of an old injury, such as old meniscus damage. For example a damaged meniscus may slowly wear down and its shock-absorbing characteristics may be gradually lost. The joint cartilage at the ends of the bones are then at risk, and may themselves start to break down and debris may go into an already irritated joint. There may be an angular deformity of the limb (eg varus or valgus deformity).

In some patients arthritis is constitutional, but affected by diet, such as in gout. In this case deposits of a chalky material may be depositied in the joint tissues.

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What is referred pain?

Referred pain is pain that feels as if it is coming from the joint, but may actually be triggered elsewhere. The common one is knee pain which is actually coming from hip arthritis.

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