Tenderness in the knee – Causes, Diagnosis & Treatment

Causes:

• Injury: Sprains (ligament tears), strains (muscle/tendon injuries), contusions (bruises), and fractures can cause knee tenderness.
• Arthritis: Osteoarthritis (wear and tear), rheumatoid arthritis (autoimmune), and other forms of arthritis can cause joint inflammation and tenderness.
• Meniscus Tear: Tears in the cartilage that cushions the knee joint can lead to pain, swelling, and tenderness, especially along the joint line.
• Bursitis: Inflammation of the bursae (fluid-filled sacs) around the knee, such as prepatellar bursitis (“housemaid’s knee”) or infrapatellar bursitis, can cause localized tenderness and swelling.
• Tendinitis: Inflammation of the tendons surrounding the knee, such as patellar tendinitis (“jumper’s knee”) or quadriceps tendinitis, can cause tenderness at the tendon insertion points.
• Osgood-Schlatter Disease: A condition affecting the tibial tubercle (where the patellar tendon attaches to the shinbone), common in adolescents undergoing growth spurts, causing tenderness and swelling at this bony prominence.
• Infection: Septic arthritis (infection in the knee joint) causes significant pain, swelling, redness, warmth, and tenderness.
• Baker’s Cyst: A fluid-filled sac that develops behind the knee, often related to arthritis or other knee problems, can cause tenderness in the back of the knee.

Diagnosis:

• Physical Exam: Careful examination of the knee, noting the location of tenderness, swelling, redness, warmth, range of motion, and stability. Specific palpation of different structures around the knee.
• Patient History: Gathering information about the onset of symptoms, any injuries, other medical conditions, and medications.
• Imaging:
  • X-rays: Essential to rule out fractures or arthritis.
  • MRI: May be used to visualize soft tissues like ligaments, tendons, cartilage, and menisci.
  • Ultrasound: Can be used to evaluate tendons and other soft tissues.

Treatment:

• RICE (Rest, Ice, Compression, Elevation): Often the initial treatment for knee injuries and inflammation.
• Pain Relief: Over-the-counter or prescription pain medication.
• Physical Therapy: Exercises to improve strength, flexibility, and range of motion.
• Assistive Devices: Crutches, walkers, or canes may be used to reduce weight bearing on the knee.
• Injections: Corticosteroid injections to reduce inflammation in some cases, such as for bursitis or tendinitis.
• Arthroscopy: A minimally invasive surgical procedure that can be used to diagnose and treat some knee problems, such as meniscus tears.
• Knee Replacement Surgery: May be necessary for severe arthritis.
• Treatment of Underlying Cause: If the tenderness is due to an underlying medical condition, treatment will be directed at that condition.

Important Considerations:

• Seek immediate medical attention if you have severe knee pain, deformity, or are unable to bear weight. This could indicate a fracture or dislocation.
• Consult a healthcare professional for persistent or unexplained knee tenderness. Do not attempt to self-treat without consulting a doctor. Early diagnosis is essential for effective treatment and to prevent complications.