Knee Pain (cont.)
What are diseases and conditions that can cause knee pain, and how are they treated?
Pain can occur in the knee from
diseases or conditions that involve the knee joint, the soft tissues and bones
surrounding the knee, or the nerves that supply sensation to the knee area. In
fact, the knee joint is the most commonly involved joint in rheumatic diseases,
immune diseases that affect various tissues of the body including the joints to cause arthritis.
Arthritis is inflammation within a joint. The causes of
knee joint inflammation range from noninflammatory types of arthritis such as
osteoarthritis, which is a degeneration of the cartilage of the knee, to
inflammatory types of arthritis (such as rheumatoid arthritis or gout).
Treatment of the arthritis is directed according to the nature of the specific type of
arthritis. For more information on arthritis, please read the following articles:
Psoriatic Arthritis and
Reactive Arthritis.
Swelling of the knee joint from arthritis can lead to a localized collection of fluid accumulating in a cyst behind the knee. This is referred to as a
Baker cyst and is a common cause of pain at the back of the knee.
Infections of the bone or joint can rarely be a serious
cause of knee pain and have associated signs of infection including fever, extreme heat,
warmth of the joint, chills of the body, and may be associated with
puncture wounds in the area around the knee.
Tumors involving the joint are extremely rare. They can cause problems
with local pain.
The collateral ligament on the inside of the knee joint
can become calcified and is referred to as Pellegrini-Stieda syndrome. With this
condition, the knee can become inflamed and can be treated conservatively
with ice packs, immobilization, and rest. Infrequently, it requires a
local injection of corticosteroids.
Chondromalacia refers to a softening of the cartilage under the kneecap
(patella). It is a common cause of deep knee pain and stiffness in younger
women and can be associated with pain and stiffness after prolonged
sitting and climbing stairs or hills. While treatment with
antiinflammatory medications, ice packs, and rest can help, long-term
relief is best achieved by strengthening exercises for the quadriceps muscles of the
front of the thigh.
Bursitis of the knee commonly occurs on the inside of the knee (anserine
bursitis) and the front of the kneecap (patellar bursitis, or "housemaid's
knee"). Bursitis is generally treated with ice packs, immobilization,
and antiinflammatory medications such as ibuprofen (Advil, Motrin) or aspirin and may require
local injections of corticosteroids (cortisone medication) as well as exercise
therapy to develop the musculature of the front of the thigh.
- The knee joint has three compartments.
- Causes of knee pain include injury, degeneration,
arthritis, infrequently infection, and rarely bone tumors.
- Ligaments within the knee (cruciate ligaments) and on
the inner and outer sides of the knee (collateral ligaments) stabilize the
joint.
- Surgical repair of ligament injury can involve
suturing, grafting, and synthetic graft repair.
- Routine X-rays do not reveal meniscus tears but can
be used to exclude other problems of the bones and other tissues.
- The knee joint is the most commonly involved joint in rheumatic
diseases, which are immune diseases that affect various tissues of the body, including
the joints, to cause arthritis.
References:
Clinical Primer of
Rheumatology, Lippincott Williams & Wilkens, edited by William Koopman, et al., 2003.
Kelley's Textbook of Rheumatology, W B Saunders Co, edited by Shaun Ruddy, et al., 2000.
Last Editorial Review: 8/18/2008
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