Common knee symptoms include:
It is important to highlight whether or not the symptom started after an injury or incident:
Knee pain coming on after injury -
- if the knee pain was agonising initially after injury and is continuing - it might be a 'fracture' (bone break). A fall onto the knee may shatter the kneecap patellar fracture). Another important fracture is a 'tibial plateau fracture'.
- if the knee pain was agonising initially after injury, was associated with a loud 'pop' and marked swelling, but the pain tended to ease later - consider that there might be a 'ligament tear', for example a cruciate ligament
- if the knee pain was severe initially after injury, with continuing pain in the joint line - consider that you might have torn a meniscus
Knee pain coming on without any injury -
Knee noises at time of injury -
- a loud pop or crack at the time of injury - suggests a 'ligament or meniscus tear'
- a loud crack with severe pain and immediate swelling - might be a 'fracture' (bone break)
- a sharp noisy snap of structures usually at the outer side or back of the knee could be a discoid lateral meniscus, an intra-articular loose body, iliotibial band friction syndrome, or subluxations of the biceps femoris and popliteus tendons.
Knee noises during ordinary activities -
- if crunchy noises on bending - it might be related to the 'kneecap'
- if there is a pop in certain position - think 'normal, or old meniscus tear or discoid meniscus'
Knee swollen immediately after injury -
- if extensive, tense, painful - there could be 'blood in the joint (haemarthrosis), with internal damage'
- if localized, tense, painful - it could be a bursa bleed'
Knee swollen during ordinary activities -
- if severe, painful - it could be 'rheumatoid condition or infection' (an emergency)
- if persistent - it could be 'internal damage or arthritis'
- if recurrent - think 'rheumatoid condition'
Again it is important to remember any injury that preceded the instability -
Instability that followed an injury
- if immediate, unable to continue activity - it might be a 'ligament tear' (collateral/cruciate)
Instability with no record of injury
Differentiate between true locking - where professional help is needed to get the knee straight again, and 'pseudolocking' where the person is able to do it themself -
- if completely locked - it could be a 'bucket handle tear of meniscus, or a big loose body'
- if intermittent pseudolocking - it could be a small 'loose body, plica, kneecap subluxation'
This is when the knee looks grossly abnormal, not just swollen -
- if sudden painful deformity - it could be a 'kneecap dislocation'
- if gross deformity following a serious injury - a 'total knee dislocation' may have occurred, with disruption of several key ligaments
- if slow onset - it might be 'arthritis'