Possible conditions
Arthritis
There are two types of arthritis: inflammatory arthritis which commonly affects small joints, hands and feet is an auto immune condition spreading to larger joints. The second type is osteoarthritis, commonly described as wear and tear and usually affecting the over 50’s.
Soft tissue problems ie tendon problems
There are a large group of problems that occur or affect the soft tissue around the knee, for example Patella Tendonitis, Iliotibial Band Friction Syndrome and Bursitis. These conditions are often associated with overuse or repetitive strain and do not often require surgery. Such knee problems are common in runners.
A bursa is a fluid filled sac which sits between moving body parts for example bone and skin or bone and tendons. A bursa helps the tissues slide easily over one another without causing friction. Imagine holding a balloon between both your hands and moving the hands – the balloon keeps the hands from rubbing on one another. Bursae sometimes become inflamed or sore and very occasionally infected. Most can be treated without surgery.
No diagnosis
Based on your selected answers you fall outside of any obvious conditions and if the symptoms persist we would recommend you seek specialist advice. Please click here to view an index of various symptoms and conditions to help you further your research, alternative click to book a consultation or let one of our team advise how you can get your GP to refer you to us.
Anterior knee pain (knee cap)
Anterior knee pain is knee pain at the front of the knee or Patellofemoral Syndrome - pain from the knee cap joint. The causes vary from muscle imbalance through to damage or wearing of the surface of the knee cap joint. This is a very common condition particularly in the younger age group. It is associated with knee cap instability or dislocation.
Patellofemoral syndrome is a condition which should really be applied to a knee in which the patient experiences pain at the front of the knee in the absence of structural problems within the knee. It is often experienced by patients when ascending or particularly descending stairs, squatting, rising from a sitting position or when significant force is put through a bent knee such as lunging sports like tennis. It is thought to be due to poor muscle strength in the quadriceps muscle group in the front of the thigh often combined with muscle imbalance or tight hamstring muscles. The mainstay of treatment is phyiotherapy and muscle strengthening and balancing.
Fracture/Injury to knee joint surface
Fracture is another word for a crack or break in the bone. It usually occurs after a substantial injury and requires urgent assessment. Sometimes you can injure the surface of the knee (osteochondral injury) where the smooth surface grinds or articular cartilage is damaged.
Damage can occur to the articular cartilage or gristle that surfaces the patella and groove in which the patella runs (the trochlea). It can be a small area of damage with normal surrounding cartilage or it can be general wear with age, use and sport. Is sometimes occurs due to maltracking of the patella where the knee cap doesn’t run centrally in the trochlea groove on the front of the thigh bone or femur. Maltracking can be addressed by physiotherapy if mild or surgery if more severe. The chondral damage can be treated by a number of escalating treatments depending on severity from physiotherapy alone through chondral debridement, radiofrequency smoothing, surgical correction of maltracking to finally, patella-femoral replacement surgery. Most patients can be helped by the simpler and non-surgical teatments.
Meniscal problem (Meniscus; footballer’s cartilage)
There are two meniscus in each knee; they are shock absorbers and can be torn following an injury (acute meniscus tear) or they can gradually wear out (meniscal degeneration). They have a limited capacity to heal.
Ligament injury
Ligaments are soft tissue ropes that hold the bones together and provide the knee with stability. The collateral ligaments sit on either side of the knee; the medial is on the inside and the lateral is on the outside. The crucial ligaments (anterior - front or posterior - back) sit in the centre of the joint ligaments are often injured by sports people, for example, in rugby or skiing and rupture - urgent assessment is needed to ensure the best possible outcome.
Bone Bruise
A bruise is one of the most common sports injuries. Typically, it is a collection of blood under the skin that heals quickly when treated with rest, ice, compression, elevation and pain medication. However, sometimes a bruise can be a sign of deeper trauma. If left untreated, some large bruises can cause some muscle damage. When seen on MRI of a post-traumatic knee, bone bruising is most often a minor feature of a more complex picture and of variable significance. It may result from direct trauma or from indirect forces which have produced patellar dislocation. In such a case anterior knee pain may persist for three or four months as part of the post-traumatic symptoms.
