Orthopedics Book


Acute Knee Pain

Aka: Acute Knee Pain, Knee Pain, Anterior Knee Pain
  1. See Also
    1. Knee Anatomy
    2. Knee Injury Acute History
    3. Knee Examination
    4. Ottawa Knee Rules
    5. Rheumatologic Conditions affecting the Knee
  2. Precautions: Pitfalls
    1. Consider referred pain (including Neuropathy or radiculopathy)
      1. Referred Hip Pain in children (e.g. SCFE, Legg-Calve-Perthes Disease)
      2. Lumbar Radiculopathy
      3. Sacroiliitis
      4. Proximal Musculoskeletal Injury (e.g. non-displaced Hip Fracture may present with Knee Pain)
    2. Consider malignancy
      1. Osteosarcoma
      2. Chondrosarcoma
      3. Ewing Sarcoma
  3. Causes: Fractures and dislocations
    1. Knee Dislocation (Tibial Femoral Dislocation) or Knee Subluxation
    2. Tibial Plateau Fracture
    3. Patella Fracture
    4. Patella Dislocation
    5. Proximal Fibula Fracture
  4. Causes: Adult Knee Pain by frequency
    1. Most common causes of Acute Knee Pain
      1. Knee Osteoarthritis (most common)
      2. Meniscus Injury
      3. Collateral Ligament Tear of Knee
      4. Anterior Cruciate Ligament Rupture (ACL Rupture)
      5. Posterior Cruciate Ligament Rupture (PCL Rupture)
      6. Acute Gouty Arthritis
      7. Fracture (see above)
    2. Uncommon but important causes of Acute Knee Pain
      1. See Rheumatologic Conditions affecting the Knee
      2. Septic Arthritis (most critical to rule-out)
      3. Rheumatoid Arthritis
      4. Pseudogout
      5. Lyme Disease
      6. Parvovirus B19
  5. Causes: Pain by location
    1. Anterior Knee Pain
      1. Patellar Subluxation or instability
      2. Osgood Schlatter or Tibial Apophysitis (adolescents)
      3. Sinding-Larsen-Johansson Syndrome or Distal Patellar Apophysitis (adolescents)
      4. Jumper's Knee
      5. Patellofemoral Syndrome
      6. Chondromalacia Patellae
      7. Prepatellar Bursitis
      8. Patellofemoral Osteoarthritis
      9. Hoffa Disease
        1. Infrapatella fat pad tenderness
      10. Osteochondritis Dissecans
      11. Patella Stress Fracture
    2. Posterior Knee Pain
      1. Baker's Cyst
      2. Posterior Cruciate Ligament Tear
      3. Tear of posterior aspect of meniscus
    3. Medial Knee Pain
      1. Medial Collateral Ligament Tear
      2. Medial Meniscus Tear
      3. Pes Anserine Bursitis
      4. Plica Syndrome
      5. Slipped Capital Femoral Epiphysis (referred pain from hip in adolescents)
    4. Lateral Knee Pain
      1. Knee Lateral Collateral Ligament Tear
      2. Lateral Meniscus Tear
      3. Iliotibial Band Syndrome
    5. Diffuse, atraumatic Knee Pain
      1. See Monoarthritis or Polyarthritis
      2. Osteoarthritis (especially over age 50 years old)
      3. Septic Joint
      4. Acute Gouty Arthritis
      5. Rheumatoid Arthritis
  6. Causes: Pain by age
    1. See Knee Injury Acute History for injury related causes
    2. Children
      1. Osteochondritis Dissecans
      2. Osgood Schlatter
      3. Jumper's Knee
      4. Patellar Subluxation
    3. Young Adults
      1. Patellofemoral Syndrome
      2. Plica Syndrome
      3. Pes Anserine Bursitis
      4. Rheumatoid Arthritis
      5. Reiter's Syndrome
      6. Septic knee
    4. Older Adults
      1. Knee Osteoarthritis
      2. Gout
      3. Pseudogout
      4. Baker's Cyst
  7. Evaluation
    1. See Knee Injury Acute History
    2. See Knee Examination
  8. Imaging: Xray indications
    1. See Ottawa Knee Rules
    2. Evaluate for Fracture or Osteoarthritis
  9. References
    1. Spangler and Tollefson (2014) in Herbert 14(6): 9-11
    2. Bunt (2018) Am Fam Physician 98(9): 576-85 [PubMed]
    3. Calmbach (2003) Am Fam Physician 68(5):917-22 [PubMed]
    4. Jackson (2003) Ann Intern Med 139:575-88 [PubMed]

Knee pain (C0231749)

Concepts Sign or Symptom (T184)
ICD10 M25.569, M25.56
SnomedCT 390076006, 202488008, 389343009, 156599003, 202474009, 30989003
English Knee(s) Pain, Arthralgias (knees), Arthralgia (knee), Knee arthralgia, localized knee joint pain, localized knee joint pain (symptom), knee joint pain, knee pain, Aching in knees, Knee pain, Pain in knee, Pain knee, Painful knee, Pain in unspecified knee, aching knees, knees aching, aching knee, knee arthralgia, Pain;musculoskeletal;knee, Pain;knee, knee pains, painful knee, gonalgia, pain in knee, arthralgia - knee / patella / tibia / fibula, arthralgia of the knee, arthralgia of the knee (diagnosis), Knee joint pain (finding), Gonalgia, Arthralgia of knee, Knee joint pain, Knee pain (finding), knee; joint pain, knee; pain, joint, musculoskeletal knee pain
Dutch pijnlijke knie, gonalgie, pijnlijke knieën, pijn knie, pijn in knie, kniepijn, knie; gewrichtspijn, knie; pijn, gewricht
French Douleur du genou, Endolorissement des genoux, Genou douloureux, Douleur dans le genou, Gonalgie
German schmerzhaftes Knie, Schmerzen in den Knien, Gonalgie, Knieschmerz, Schmerz im Knie, Schmerz Knie
Italian Dolore al ginocchio, Ginocchio dolorante, Gonalgia, Dolore alle ginocchia
Portuguese Dor no joelho, Joelho doloroso, Gonalgia, Moinha nos joelhos
Spanish Dolor en rodilla, Gonalgia, Dolor de rodilla, Rodillas doloridas, Rodilla dolorosas, dolor de rodillas, gonalgia (hallazgo), gonalgia
Japanese 膝痛, 膝関節痛, シツツウ, ヒザカンセツツウ, シッツウ, シツカンセツツウ, ヒザツウ
Czech Bolest kolene, Pobolívání v kolenou, Bolestivé koleno, Bolest v koleni, Gonalgie
Hungarian Fájdalom a térdben, Gonalgia, Fájdalmas térd, Fájás a térdekben, Térdfájdalom
Derived from the NIH UMLS (Unified Medical Language System)

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