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General evaluation of the adult with knee pain

Author
Bruce C Anderson, MD
Section Editor
Karl B Fields, MD
Deputy Editor
Jonathan Grayzel, MD, FAAEM

INTRODUCTION

The knee is the largest human joint in terms of its volume and surface area of articulating cartilage. The knee joint has the greatest susceptibility to injury, age-related wear and tear, inflammatory arthritis, and septic arthritis [1].

This review provides a general approach to the evaluation of knee pain in adults. An in-depth discussion of how to assess knee pain in the active adult or adult athlete, who is more likely to have sustained a musculoskeletal injury, is found separately. More in-depth discussions of the diagnosis and treatment of specific disorders of the knee are also provided separately. (See "Approach to the athlete or active adult with knee pain" and "Radiologic evaluation of the acutely painful knee in adults".)

BASIC KNEE ANATOMY AND BIOMECHANICS

The anatomy and biomechanics of the knee are reviewed separately. (See "Approach to the athlete or active adult with knee pain", section on 'Basic knee anatomy and biomechanics'.)

PRESENTATION

Overview — Knee pain can be broadly categorized as due to one or more of the following:

An intraarticular process such as a meniscal or ligamentous injury (internal derangement) or fracture

                                      

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Literature review current through: Nov 2016. | This topic last updated: Mon Apr 18 00:00:00 GMT 2016.
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References
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  1. Anderson BC. Office Orthopedics for Primary Care: Diagnosis and Treatment, 2nd, WB Saunders, Philadelphia 1999.
  2. Altman R, Asch E, Bloch D, et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum 1986; 29:1039.
  3. Bhattacharyya T, Gale D, Dewire P, et al. The clinical importance of meniscal tears demonstrated by magnetic resonance imaging in osteoarthritis of the knee. J Bone Joint Surg Am 2003; 85-A:4.
  4. Bolzan JA, O'Sullivan JB, Cathcart ES. Unexpected prevalence of knee-joint effusions in the population of Sudbury. Arthritis Rheum 1972; 15:253.
  5. Bomberg BC, McGinty JB. Acute hemarthrosis of the knee: indications for diagnostic arthroscopy. Arthroscopy 1990; 6:221.
  6. Maffulli N, Binfield PM, King JB, Good CJ. Acute haemarthrosis of the knee in athletes. A prospective study of 106 cases. J Bone Joint Surg Br 1993; 75:945.
  7. Cea-Pereiro JC, Garcia-Meijide J, Mera-Varela A, Gomez-Reino JJ. A comparison between septic bursitis caused by Staphylococcus aureus and those caused by other organisms. Clin Rheumatol 2001; 20:10.
  8. Dawn B, Williams JK, Walker SE. Prepatellar bursitis: a unique presentation of tophaceous gout in an normouricemic patient. J Rheumatol 1997; 24:976.
  9. Yates C, Grana WA. Patellofemoral pain--a prospective study. Orthopedics 1986; 9:663.
  10. Messier SP, Edwards DG, Martin DF, et al. Etiology of iliotibial band friction syndrome in distance runners. Med Sci Sports Exerc 1995; 27:951.
  11. Niva MH, Kiuru MJ, Haataja R, Pihlajamäki HK. Bone stress injuries causing exercise-induced knee pain. Am J Sports Med 2006; 34:78.
  12. Stiell IG, Greenberg GH, Wells GA, et al. Prospective validation of a decision rule for the use of radiography in acute knee injuries. JAMA 1996; 275:611.
  13. Bachmann LM, Haberzeth S, Steurer J, ter Riet G. The accuracy of the Ottawa knee rule to rule out knee fractures: a systematic review. Ann Intern Med 2004; 140:121.
  14. Stiell IG, Greenberg GH, Wells GA, et al. Derivation of a decision rule for the use of radiography in acute knee injuries. Ann Emerg Med 1995; 26:405.