Acute knee pain
- Inflammatory Knee Pain: Inflammation that occurs in certain rheumatic diseases, such as rheumatoid arthritis and systemic lupus erythematosus, can damage the knee.
- ACL rupture (anterior cruciate ligament rupture).
- PCL rupture (posterior cruciate ligament rupture).
- Medial meniscus injury.
- Lateral meniscus injury.
- Medial lateral collateral ligament injury.
- Lateral collateral ligament injury.
- Acute gouty arthritis.
- Swelling of the knee.
- Pain worsen with walking downstairs, hills.
- Also feel pain when climbing stairs.
- Presence and location of swelling (intraarticular, prepatellar bursa, posterior).
- Presence and location of warmth.
- Presence and location of crepitus.
- Foot pulses.
- Palpate for tenderness (peripatellar, patella, patella tendon, tibial tuberosity, medial and lateral joint lines, medial and lateral collateral ligaments, and pes anserine bursa).
- Apprehension and pain with lateral displacement of patella for indications of patella subluxation or dislocation.
- Active range of motion.
- Passive range of motion.
- Joint line pain with extension or flexion is compatible with meniscus tear.
- Meniscal compression tests (McMurray's, Appley's) to evaluate for torn meniscus.
- Varus/valgus instability (0° & 30° of flexion) for damage to collateral ligaments.
- Evaluate hip range of motion for underlying hip pathology.
- CAT (computerized axial tomography) scan of the knee.
- Bone scan.
- MRI scan.
- Rest, Ice: 15-20 minutes every 3-4 hours for first 24-48 hours.
- Crutches: Should be used if unable to bear full weight without pain or for specific conditions for which non-weight bearing is indicated (e.g., fractures, osteochondritis dissecans). If partial weight bearing is acceptable, encourage range of motion and weight bearing as tolerated.
- Bracing: Indicated only if injury is unstable and needs immobilization, or for specific support of an injured structure when the diagnosis has been established (e.g., collateral ligament sprains). Routine use of immobilizers is discouraged because resulting stiffness and pain delays recovery.
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