Symptom Finder - Knee Pain
Knee Pain
Once again, the physician should obtain an x-ray to rule out fracture in most cases of acute knee pain before proceeding with an extensive clinical evaluation. This evaluation includes range of motion (extension and flexion) and palpation. Test for loose collateral ligaments by fully
extending the joint at the knee and attempting to move the tibia, medially and laterally. Next, perform a McMurray test. Flex the knee on the thigh and with the foot rotated first internally and then externally slowly extend the knee. If a “pop” or locking of the joint is heard, the test is positive for a torn meniscus, and a referral to an orthopedic surgeon is necessary.
Finally, use the drawer test to check for anterior or posterior cruciate ligament tears or rupture. With the foot dangling over the examination table, attempt to pull the tibia forward and backward on the femur. If there is significant movement one way or the other, the test is positive. Examine the knee for fluid by pressing the patella distally and feeling for ballottement (the patella bobs up and down on pressure).
There are several bursa around the knee. It is worthwhile to inject them with 1% to 2% lidocaine to see if significant relief of knee pain is
achieved.
Here again, one must examine the patient for a possible herniated lumbar disc. Look for hip pathology as well.
Once again, the physician should obtain an x-ray to rule out fracture in most cases of acute knee pain before proceeding with an extensive clinical evaluation. This evaluation includes range of motion (extension and flexion) and palpation. Test for loose collateral ligaments by fully
extending the joint at the knee and attempting to move the tibia, medially and laterally. Next, perform a McMurray test. Flex the knee on the thigh and with the foot rotated first internally and then externally slowly extend the knee. If a “pop” or locking of the joint is heard, the test is positive for a torn meniscus, and a referral to an orthopedic surgeon is necessary.
Finally, use the drawer test to check for anterior or posterior cruciate ligament tears or rupture. With the foot dangling over the examination table, attempt to pull the tibia forward and backward on the femur. If there is significant movement one way or the other, the test is positive. Examine the knee for fluid by pressing the patella distally and feeling for ballottement (the patella bobs up and down on pressure).
There are several bursa around the knee. It is worthwhile to inject them with 1% to 2% lidocaine to see if significant relief of knee pain is
achieved.
Here again, one must examine the patient for a possible herniated lumbar disc. Look for hip pathology as well.