Knee pain

Knee pain is a common complaint for many people. There are several factors that can cause knee pain. Awareness and knowledge of knee pain causes lead to faster diagnosis and treatment. Knee pain can be related to knee joint or around the knee.

Knee joint

The knee joint consists of three bones: the femur, tibia, and patella. There are three compartments to the knee. The main joint of the knee is called tibiofemoral joint that includes the medial and lateral compartments. The patella and the femur form the patellofemoral joint. This is the third compartment of the knee.

Injuries

Some common injuries include:

• Sprain (Ligament sprain)
  • Medial collateral ligament
  • Lateral collateral ligament
  • Anterior cruciate ligament
  • Posterior cruciate ligament

• Tear of meniscus
  • Medial meniscus
  • Lateral meniscus

• Strain (Muscle strain)
  • Quadriceps muscles
  • Hamstring muscles
  • Popliteal muscle
  • Patellar tendon
  • Hamstring tendon
  • Popliteal tendon

• Hemarthrosis. Hemarthrosis tends to develop over a relatively short period after injury, from several minutes to a few hours.^[1]

Diseases

Some of the diseases of cause of knee pain include:

• Knee osteoarthritis
• Chondromalacia patella
• Baker's cyst
• Meniscal cyst
• Discoid meniscus
• Osgood-Schlatter disease
• Larsen-Johansson disease
• Knee rheumatoid arthritis
• Osteochondritis dissecans disease
• Synovial chondromatosis disease
• Tumors
• Ankylosing spondylitis
• Reiter's syndrome
• Tuberculosis arthritis
• Septic arthritis (Pyogenic arthritis)
• Osteomyelitis
• Hemophilic arthritis
• Gout (Gouty arthritis)

Inflammations

• Bursitis of the knee
  • Prepatellar bursitis - Housemaid's knee (most common)
  • Infrapatellar bursitis - Clergyman's knee (Superficial infrapatellar bursitis and Deep infrapatellar bursitis)
  • Semimembranosus bursitis

• Tendinitis
  • Patellar tendinitis (Jumper's knee)
  • Hamstring tendinitis
  • Popliteal tendinitis

• Synovitis of the knee

Deformities

Common deformities of the knee include:

• Genu varum
• Genu valgum
• Genu recurvatum (Knee hyperextension)
• Knee flexion deformity
• Bipartite patella

Syndromes

• Patellofemoral pain syndrome (Runner's knee)
• Plica syndrome
• Iliotibial band syndrome

Fractures

• Femoral fracture
• Tibial fracture
• Patella fracture

Dislocations

• Patella dislocation
• Knee joint dislocation (Tibiofemoral joint dislocation)

Referred knee pain

Referred pain is that pain perceived at a site different from its point of origin but innervated by the same spinal segment.^[2] Sometimes knee pain may be related to another area from body. For example, knee pain can come from ankle, foot, hip joints or lumbar spine.

See also: Referred pain

Cold-induced

A Chinese study came to the result that knee pain is significantly more prevalent in people working in cold stores than in those in normal temperature.^[3]

One study came to the result that 17% of adolescents with anterior knee pain (a common but benign self-limiting condition) report that their pain is associated with cold weather.^[4] The same study indicated that the main activities associated with anterior knee pain are sporting, stair climbing and walking, but also sitting.^[4] Some people with anterior knee pain tend to have generally colder knees, and such people also trend towards having to wear extra tights/long johns in the winter.^[5]

Cold-induced knee pain may also be due to tenosynovitis of the tendons around the knee, in which cold exposure has a specific role, either as a causative or a contributing factor.^[3] Frank arthritis has been reported in children due to frostbite from extreme cold causing direct chondrocyte injury.^[6]

There is also a hereditary disease, familial cold autoinflammatory syndrome (FCAS), which often features knee pain, in addition to hives, fever and pain in other joints, following general exposure to cold.^[7]

Cold weather also aggravates knee pain in patients already having osteoarthritis, rheumatoid arthritis and fibromyalgia.^[8]

Other causes

• Ligamentous laxity
• Fat pad impingement
• Knee effusion
• Deep vein thrombosis
• Peripheral vascular disease

References

1. ^ Darlene Hertling and Randolph M.Kessler. Management of Common Musculoskeletal Disorders. Third Edition. ISBN 0-397-55150-9
2. ^ Carol Mattson Porth. Pathophysiology:concepts of altered health states. Publisher:Lippincott. Third Edition. Page 853. ISBN 0-397-54723-4
3. ^ ^{a b} Pienimäki, T (2002). "Cold exposure and musculoskeletal disorders and diseases. A review". International journal of circumpolar health 61 (2): 173–82. PMID 12078965.  edit [1]
4. ^ ^{a b} [2] Sandow, MJ; Goodfellow, JW (1985). "The natural history of anterior knee pain in adolescents". The Journal of bone and joint surgery. British volume 67 (1): 36–8. PMID 3968140.  edit
5. ^ Selfe, J.; Sutton, C.; Hardaker, N. J.; Greenhalgh, S.; Karki, A.; Dey, P. (2010). "Anterior knee pain and cold knees: A possible association in women". The Knee 17 (5): 319. doi:10.1016/j.knee.2009.10.005. PMID 19884010.  edit
6. ^ Carrera, G. F.; Kozin, F.; McCarty, D. J. (1979). "Arthritis after frostbite injury in children". Arthritis & Rheumatism 22: 1082. doi:10.1002/art.1780221006.  edit
7. ^ clinicaltrials.gov > Pathogenesis of Physical Induced Urticarial Syndromes National Institutes of Health Clinical Center (CC), December 2010
8. ^ Arthritis Special Report - Does Weather Affect Arthritis Pain? From Johns Hopkins Health Alerts, Johns Hopkins Hospital