{"id":413,"date":"2017-03-26T14:07:10","date_gmt":"2017-03-26T14:07:10","guid":{"rendered":"http:\/\/papergp.com\/index.php\/rheumatology-and-musculoskeletal\/knee-pain\/"},"modified":"2023-01-24T11:25:26","modified_gmt":"2023-01-24T11:25:26","slug":"knee-pain","status":"publish","type":"page","link":"https:\/\/papergp.com\/index.php\/rheumatology-and-musculoskeletal\/knee-pain\/","title":{"rendered":"Knee pain"},"content":{"rendered":"<div class=\"content-box-blue\">\n<h4>Differential diagnosis<\/h4>\n<ul>\n<li>Septic joint &#8211; fever, systemically unwell, red, swollen<\/li>\n<li>Osteoarthritis &#8211; wear and tear of joint &#8211; gradual onset of pain, stiffness, reduced ROM, crepitus<\/li>\n<li>Meniscal injury- sudden twisting, locking, recurrent effusion after activity, moderate effusion within 36 hours<\/li>\n<li>Ligament injury\n<ul>\n<li>popping at time of injury, knee gives way, large and tense effusion within 2 hours<\/li>\n<li>Mechanism:\n<ul>\n<li>Anterior cruciate ligament injury &#8211; sharp turns and sudden stops or hyperextension<\/li>\n<li>Posterior cruciate ligament injury &#8211; blow to anterior aspect of knee while in flexion (in RTA where knee hits dashboard)<\/li>\n<li>Medial collateral ligament &#8211; blow to lateral aspect of knee<\/li>\n<li>Lateral collateral ligament &#8211; blow to medial aspect of knee (more common)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li>Patellar tendonitis &#8211; pain over patella often from repetitive overloading e.g jumping &#8211; knee swelling, patellar tenderness<\/li>\n<li>Chondro-malacia patella &#8211;\u00a0young girl, anterior knee pain worse on stairs &#8211; crepitus, fluid behind knee<\/li>\n<li>Osgood-Schlatter&#8217;s &#8211; teenage boys, pain and swelling below knee<\/li>\n<li>Baker&#8217;s cyst &#8211; fluid filled swelling that develops at the back of the knee &#8211; pain, swelling, locking<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4>Data gathering<\/h4>\n<ul>\n<li>Red flag &#8211; fever, systemically unwell<\/li>\n<li>Others &#8211; locking, giving way, trauma, swelling (timing of swelling), rest pain<\/li>\n<li>Examine\n<ul>\n<li>Look &#8211; symmetry, wasting, swelling, redness<\/li>\n<li>Feel &#8211; temperature, joint line, patella tenderness<\/li>\n<li>Move &#8211; flexion, extension, cruciate and collateral ligaments<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4>Clinical management<\/h4>\n<ul>\n<li>Investigations\n<ul>\n<li>Xray &#8211; if degenerative change suspected<\/li>\n<li>MRI &#8211; if likely result can be managed in community<\/li>\n<\/ul>\n<\/li>\n<li>Treatment\n<ul>\n<li>Septic arthritis\n<ul>\n<li>Refer to orthopaedics same day<\/li>\n<\/ul>\n<\/li>\n<li>\u00a0OA\n<ul>\n<li>see OA<\/li>\n<\/ul>\n<\/li>\n<li>Meniscal problem\n<ul>\n<li>analgesia, rest, surgery (for larger tears)<\/li>\n<\/ul>\n<\/li>\n<li>Ligamentous injury\n<ul>\n<li>analgesia, rest, physiotherapy, surgery<\/li>\n<\/ul>\n<\/li>\n<li>Patellar tendonitis\n<ul>\n<li>analgesia, rest, knee exercises, steroid injection<\/li>\n<\/ul>\n<\/li>\n<li>Chondro-malacia patellae\n<ul>\n<li>avoid repetitive knee bending, rest, analgesia, knee supports, surgery<\/li>\n<\/ul>\n<\/li>\n<li>Osgood-Schlatter&#8217;s\n<ul>\n<li>analgesia, ice, knee support, reduce strenuous activity, knee support, physiotherapy<\/li>\n<\/ul>\n<\/li>\n<li>Baker&#8217;s cyst\n<ul>\n<li>Tx: self limiting, analgesia, RICE, surgery<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li>Follow-up \/ Safety-net\n<ul>\n<li>Consider referral\n<ul>\n<li>Red flags<\/li>\n<li>Joint instability<\/li>\n<li>Severe pain<\/li>\n<li>Surgery indicated<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>Nb:<\/p>\n<ul>\n<li>Knee exercises &#8211; sit\/stand without hands, knee squats<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Differential diagnosis Septic joint &#8211; fever, systemically unwell, red, swollen Osteoarthritis &#8211; wear and tear of joint &#8211; gradual onset of pain, stiffness, reduced ROM, crepitus Meniscal injury- sudden twisting, locking, recurrent effusion after activity, moderate effusion within 36 hours Ligament injury popping at time of injury, knee gives way, large and tense effusion within &hellip; <a href=\"https:\/\/papergp.com\/index.php\/rheumatology-and-musculoskeletal\/knee-pain\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Knee pain<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":408,"menu_order":169,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-413","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/413","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/comments?post=413"}],"version-history":[{"count":8,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/413\/revisions"}],"predecessor-version":[{"id":2030,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/413\/revisions\/2030"}],"up":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/408"}],"wp:attachment":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/media?parent=413"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}