Anterior knee pain and patellar instability is a difficult condition to treat. A careful physical examination is the most important means of reaching a correct diagnosis. Imaging help to confirm the diagnosis.
History
1. Determine whether the main symptom is anterior knee pain or instability
2. Bilateral knee symptoms and absence of traumatic injury should point to patellofemoral pathology as against meniscal injury. It is common to have pain in both knees that may change from one knee to the other over time. Onset of symptoms is insidious. Often there will be a history of overuse or new activity.
3. Presence of effusion points to intra-articular pathology (meniscal injury, loose bodies, plicae,synovitis)
4. Pain related to extensor mechanism is exacerbated by physical activity, descending stairs,prolonged sitting(movie sign or theater sign) and improves by extending the knee.
5.Constant pain or pain out of proportion should raise the suspicion of psychological causes or RSD
6. Do not forget PCL injury which is one of the cause of anterior knee pain
7. Check the ACL, chronic ACL insufficiency causes anterior knee pain in 20-27% of cases
Will continue with physical examination.
Posted by www.ortho-hub.com
History
1. Determine whether the main symptom is anterior knee pain or instability
2. Bilateral knee symptoms and absence of traumatic injury should point to patellofemoral pathology as against meniscal injury. It is common to have pain in both knees that may change from one knee to the other over time. Onset of symptoms is insidious. Often there will be a history of overuse or new activity.
3. Presence of effusion points to intra-articular pathology (meniscal injury, loose bodies, plicae,synovitis)
4. Pain related to extensor mechanism is exacerbated by physical activity, descending stairs,prolonged sitting(movie sign or theater sign) and improves by extending the knee.
5.Constant pain or pain out of proportion should raise the suspicion of psychological causes or RSD
6. Do not forget PCL injury which is one of the cause of anterior knee pain
7. Check the ACL, chronic ACL insufficiency causes anterior knee pain in 20-27% of cases
Will continue with physical examination.
Posted by www.ortho-hub.com
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