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Knee Pain

Scott M. Goldberg, MD and J. Herbert Stevenson, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

A common outpatient complaint with a broad differential 
  • Knee pain may be acute, chronic, or an acute exacerbation of a chronic condition.

  • Trauma, overuse, and degenerative change are ...

DIAGNOSIS

HISTORY

  • Pain location, quality, and mechanism of injury guide diagnostic reasoning (also see “Differential Diagnosis”):

    • Diffuse pain: OA, patellofemoral pain syndrome, chondromalacia

    • Pain ascen...

TREATMENT

GENERAL MEASURES

Acute injury: PRICEMM therapy (protection, relative rest, ice, compression, elevation, medications, modalities) 

MEDICATION

First Line

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Activity modification in overuse conditions

  • Rehabilitative exercise in OA:

    • Low-impact exercise: walking, swimming, cycling

    • Strength, ROM, and proprioception training

Patient Monitoring

REFERENCES

1
Hong E, Kraft MC. Evaluating anterior knee pain. Med Clin North Am.  2014;98(4):697–717. [View Abstract on OvidMedline]
2
Ayhan E, Kesmezacar H, Akgun I. Intraarticular injections (cort...

ADDITIONAL READING

  • Collins NJ, Bisset LM, Crossley KM, et al. Efficacy of nonsurgical interventions for anterior knee pain: systematic review and meta-analysis of randomized trials. Sports Med.  ...

CODES

ICD10

  • M25.569 Pain in unspecified knee

  • M17.9 Osteoarthritis of knee, unspecified

  • M76.50 Patellar tendinitis, unspecified knee

  • M17.10 Unilateral primary osteoarthritis, unspecified knee

  • M25.461 Effusi...

CLINICAL PEARLS

  • A careful history (location/quality of pain and mechanism of injury) targets diagnosis for most causes of knee pain.

  • Consider ligamentous injury, meniscal tear, and fracture for patient...

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