Differential Diagnosis of Knee Pain Commonly Encountered in Clinical Practice.
10.4078/jkra.2007.14.3.185
- Author:
Sae Kwang KWON
1
;
Chong Bum CHANG
Author Information
1. Joint Reconstruction Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea. drchuc@chol.com
- Publication Type:Review
- Keywords:
Knee pain;
Differential diagnosis
- MeSH:
Diagnosis, Differential*;
Humans;
Joints;
Knee Joint;
Knee*;
Patellofemoral Joint;
Physical Examination;
Quality of Life;
Range of Motion, Articular;
Walking;
Weight-Bearing
- From:The Journal of the Korean Rheumatism Association
2007;14(3):185-195
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
The knee is a complex structure and far from being the simple hinge joint of popular belief. Knee pain would not be properly understood unless one is familiar with the anatomy and understands the role of the various structures. For patient consultation or for selecting a treatment option, it is crucial to find the central cause of symptoms and functional disabilities of the patient based on a detailed history, a focused examination and, when indicated, the selective use of appropriate imaging and laboratory studies. The history taking should be comprehensive and include the demographic characteristics, past medical history, comprehending the associated trauma, pain characteristics and quality of life. Basic physical examination should include inspection of walking pattern and the knee, evaluation of joint effusion, range of motion and the location of tenderness, and precise assessment of joint stability. Although many advanced diagnostic tools are available, plain radiographs are frequently utilized as a primary tool to evaluate conditions of the knee joint for practical and economic reasons. A weight-bearing anteroposterior radiographs should be taken for appropriate evaluation of the condition of the tibiofemoral joint, and weight-bearing radiographs in semi-flexed position is valuable to evaluate the joint space more precisely. To evaluate the patellofemoral joint, axial and lateral views should be included in the routine radiographs. In practice, physicians need to be cautious not to easily reach the conclusion that the symptoms of the knee joint can be attributed to only a few clinical findings in consulting the patients with knee pain.
