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Evaluation of Patients Presenting with Knee Pain: Part I. History, Physical Examination, Radiographs, and Laboratory Tests

Evaluation of Patients Presenting with Knee Pain: Part I. History, Physical Examination, Radiographs, and Laboratory Tests

Knee pain is a common health issue among athletes and the general population alike. Although symptoms of knee pain can be debilitating and frustrating, knee pain is often a very treatable health issue. The knee is a complex structure made up of three bones: the lower section of the thighbone, the upper region of the shinbone, and the kneecap. 

Powerful soft tissues, such as the tendons and ligaments of the knee as well as the cartilage beneath the kneecap and between the bones, hold these structures together in order to stabilize and support the knee. However, a variety of injuries and/or conditions can ultimately lead to knee pain. The purpose of the article below is to evaluate patients with knee pain.

Abstract


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What is a Quadriceps Tendon Rupture?

What is a Quadriceps Tendon Rupture?

The tendons are powerful soft tissues which connect the muscles to the bones. One of these tendons, the quadriceps tendon, works together with the muscles found at the front of the thigh in order to straighten the leg. A quadriceps tendon rupture can affect an individual’s quality of life.

A quadriceps tendon rupture can be a debilitating injury and it usually requires rehabilitation and surgical interventions to restore knee function. These type of injuries are rare. Quadriceps tendon ruptures commonly occur among athletes who perform jumping or running sports.

Quadriceps Tendon Rupture Description

The four quadriceps muscles come together above the kneecap, or patella, to form the quadriceps ten

What is Knee Plica Syndrome?

What is Knee Plica Syndrome?

The knee is a made up of a variety of complex soft tissues. Enclosing the knee joint is a fold at its membrane known as the plica. The knee is encapsulated by a fluid-filled structure called the synovial membrane. Three of these capsules, known as the synovial plicae, develop around the knee joint throughout the fetal stage and are absorbed before birth.

However, during one research study in 2006, researchers found that 95 percent of patients undergoing arthroscopic surgery had remnants of their synovial plicae. Knee plica syndrome occurs when the plica becomes inflamed, generally due to sports injuries. This often takes place in the center of the kneecap, known as medial patellar plica syndrome.

What are the Symptoms of Knee Plica Syndrome?

The m

What is Chondromalacia Patellae?

What is Chondromalacia Patellae?

Chondromalacia patellae, also referred to as runner’s knee, is a health issue in which the cartilage beneath the patella, or kneecap, becomes soft and ultimately degenerates. This problem is prevalent among young athletes, however, it may also develop in older adults who suffer from arthritis of the knee.

Sports injuries like chondromalacia patellae are frequently regarded as an overuse injury. Taking some time off from participating in physical activities and exercise may produce superior outcomes. In the instance that the individual’s health issues are due to improper knee alignment, rest may not offer pain relief. Symptoms of runner’s knee include knee pain and grinding sensations.

What Causes Chondromalacia

What is Osgood-Schlatter Disease?

What is Osgood-Schlatter Disease?

Osgood-Schlatter disease is a common cause of knee pain in growing adolescents. It is characterized by the inflammation of the site below the knee where the tendon from the kneecap, or the patellar tendon, attaches to the shinbone, or tibia. Osgood-Schlatter disease occurs during growth spurts when muscles, bones, tendons, and other tissues shift rapidly.

Physical activities can place additional stress on the bones, muscles, tendons and other complex structures of young athletes. Children and adolescents who participate in running and jumping sports have a higher chance of developing this condition. However, less active children and adolescents may also experience this well-known health issue.

In the majority of instances, Osgood-Schlatte

What Is Sinding-Larsen-Johansson Syndrome?

What Is Sinding-Larsen-Johansson Syndrome?

Sinding-Larsen-Johansson, or SLJ, syndrome is a debilitating knee condition that most commonly affects teens during periods of rapid growth. The kneecap, or patella, is attached to the shinbone, or tibia, from the patellar tendon. The tendon connects to an expansion plate at the bottom of the kneecap throughout growth.

Repetitive stress on the patellar tendon can make the growth plate within the knee become inflamed and irritated. SLJ mainly develops in children and adolescents between the ages of 10 and 15 because that is when most people experience growth spurts. SLJ is most common in young athletes due to excess or repetitive strain in the knee.

Causes of SLJ Syndrome

The large mus

What is Patellar Tendinitis?

What is Patellar Tendinitis?

Patellar tendinitis is a common health issue characterized by the inflammation of the tendon which joins the kneecap, or patella, to the shinbone, or tibia. The knee pain associated with this problem may range from mild to severe depending on the circumstances of the knee injury.

Patellar tendinitis, or jumper’s knee, is a well-known sports injury among athletes who play in basketball and volleyball. Among recreational volleyball players, an estimated 14.4 percent of them have jumper’s knee, where the incidence is even higher for professional athletes. An estimated 40 to 50 percent of elite volleyball players have patellar tendinitis.

Causes of Patellar Tendinitis

Patellar tendinitis is caused by repeti

Bisphosphonates: Mechanism of Action and Role in Clinical Practice

Bisphosphonates: Mechanism of Action and Role in Clinical Practice

Bisphosphonates are a type of drug/medication which blocks the loss of bone density to treat osteoporosis-related ailments. They are most frequently prescribed for the treatment of osteoporosis. Bisphosphonates have two phosphonate groups. Evidence demonstrates that they reduce the probability of fractures in post-menopausal women with osteoporosis.

Bone tissue undergoes continuous remodeling that is stored to provide equilibrium, or homeostasis, through osteoblasts generating bone and osteoclasts ruining bone. Bisphosphonates inhibit bone digestion by encouraging osteoclasts to undergo apoptosis or cell death.

The uses of bisphosphonates include the prevention and treatment of osteoporosis, Paget’s disease of bone, bone metastasis (with or without hypercal

What is Metastatic Bone Disease?

What is Metastatic Bone Disease?

Cancer which develops in specific organs of the human body, including the lungs, breast, or prostate, among others, can sometimes spread into the bone, causing what is known as metastatic bone disease, or MBD. Approximately more than 1.2 million new cancer cases are diagnosed every year, where about 50 percent can spread, or metastasize, to the bones.

Through medical advancements, patients diagnosed with several different types of cancers, especially lung, breast, and prostate cancer, can live longer. However, primary cancers in more patients go through bone metastases, where they disperse to the bone. Meanwhile, other types of cancers do not disperse so easily to the bone. The most common cancers which develop in the organs and spread to the bones include:

Femoroacetabular Impingement

Femoroacetabular Impingement

Femoroacetabular impingement, or FAI, is a medical state where additional bone develops in a single or multiple of the bones which make up the hip joint, giving the bones an irregular form. As a result, the bones may rub against each other since they do not fit together properly. This friction can ultimately harm the joint, causing pain, discomfort and limiting movement.

Anatomy

The hip is commonly characterized as a ball-and-socket joint. The acetabulum, which is part of the large pelvis bone, forms the socket of the joint. The ball of the joint is the femoral head, that is the upper end of the thighbone or femur. A type of soft tissue, known as articular cartilage, covers the surface of the ball-and-socket hip joint.

Bisphosphonate-Related Proximal Femoral Fractures

Bisphosphonate-Related Proximal Femoral Fractures

With the increase of osteoporosis in older adults, the diagnosis and treatment of abnormal hip fractures, such as bisphosphonate-related proximal femoral fractures, has become more important. According to Dr. Edward J. Fox, MD, obesity is often managed through the long-term use of bisphosphonate treatment, which can inhibit osteoclast-mediated bone regeneration. Over the prolonged utilization of bisphosphonate, patients  may develop atypical proximal femoral fractures.

Understanding Atypical Femur Fractures

Atypical femur fractures are characterized as stress fractures which commonly occur in the proximal one-third of the diaphyseal bone, although

Impacted Femoral Neck Fractures

Impacted Femoral Neck Fractures

Hip fractures are characterized as any type of break in the upper region of the femur or thigh bone. The variety of broken bones generally depends on the circumstances and the force applied to the bone, where some can be more common than others. Impacted femoral neck fractures are common hip fractures which occur in many older adults in the United States.

Anatomy of Impacted Femoral Neck Fractures

The hip is a ball-and-socket joint which provides the femur the ability to bend and rotate at the pelvis. While any form of broken bones in the thigh bone or femur is considered a hip fracture, damage or injury to the socket, or acetabulum, itself is not considered a hip fracture. Below we will discuss hip fractures, particularly impacted femoral neck fractures, among others.

Femoral Neck Stress Fractures

Femoral Neck Stress Fractures

The hip is a ball-and-socket joint composed of the head of the thigh bone, or femur, which acts as the ball and fits into the round socket of the hip bone, or acetabulum. The neck of the femur is located under the ball of the hip joint. Stress fractures to the femoral neck can entirely or partially detach the femoral head from the rest of the femur.

Femoral neck stress fractures can be either displaced, where the bone is transferred out of its normal position, or non-displaced, where the bone remains stable. These fractures may interrupt blood flow to the portion of the broken bone. In recovery, the blood supply prevents severely displaced femoral neck stress fractures from healing correctly.

Causes and Symptoms of Femoral Neck Stress Fractures


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Osteitis Pubis Treatment

Osteitis Pubis Treatment

Pain along the pelvis and groin region is known as osteitis pubis. Osteitis pubis develops through the inflammation of the pubic symphysis, or the joints of the major pelvic bones found at the front of the pelvis.

The pubic symphysis is a thin joint which generally provides very minimal motion. The joint retains the two sides of the pelvis together in the front, where they connect at the sacrum in the rear side of the pelvis.

Osteitis Pubis Symptoms

Osteitis pubis is commonly characterized by pain in the front of the pelvis. Other causes of pelvic pain, such as a strain or a sprain, are frequently confused and diagnosed as osteitis pubis. While many patients report painful symptoms on one side, the pain typically occurs in the mid

Piriformis Syndrome Management

Piriformis Syndrome Management

Sciatica is a collection of symptoms in the low back, which radiate down one or both legs. Sciatica is generally caused by the compression or irritation of the sciatic nerve, the largest nerve in the human body. One of the most common health issues that cause sciatic nerve pain is called piriformis syndrome. The piriformis muscle stretches from the front of the sacrum, the triangle-shaped bone between the hipbones on the pelvis.

The piriformis muscle extends to the top of the femur around the sciatic nerve. The femur, as previously mentioned, is the large bone in the upper leg. The piriformis muscle functions by helping the thigh move from side to side. A piriformis muscle spasm, or any other type of injury and/or condition along the piriformis muscle, can place pressure on the sciatic nerve and cause pain and discomfort. The resu

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