Etiology of Knee Pain

Prevalence USA: 13% [Cunningham LS, et al. 1984] UK: 35.2% [Arden NK, et al. 2006] Australia: 48% [Zliai G, et al. 2006] China: 13.6% [Zeng QY, et al. 2006]

Anatomy The joint consist of 3 compartment: Joint Lines: Medial Tibiofemoral Lateral Tibiofemoral Patellofemoral Joint Lines: Femoral condyles Tibial Plateaus

Anatomy Meniscal Cartilage : Medial Lateral

Anatomy Ligaments: Ant & Post Cruciate Med & Latt Collateral

Anatomy Bursa: Prepattelar Inferapattelar Anserin Tendons Muscles

Etiology of Knee Pain meniscal or ligamentous injury or fracture Patellar malalignment or dysfunction Cartilage loss due to osteoarthritis or synovitis Periarticular bursitis or tendonitis Referred pain from the hip, femur, or spine Inflammatory arthritides (synovitis)

Pattern of Knee Pain Medial (the most common) Anterior Popliteal (Posterior) Lateral

Etiology of Medial Knee Pain medial compartment osteoarthritis bursitis medial collateral ligament strain (the most frequently injured ligament) medial meniscal tear

bursitis anserine the most frequently inflamed bursa & the bursa adjacent to the medical collateral ligament

Etiology of Medial joint line pain osteoarthritis medial collateral ligament injuries medial meniscal tears fractures of the tibial plateau Medial tibial plateau pain : anserine bursitis

Etiology of Anterior Knee Pain acute prepatellar bursitis swelling and inflammatory change anterior to the patella

Etiology of Anterior Knee Pain patellar tendonitis or jumper's knee Focal at the inferior pole of the patella

Etiology of Anterior Knee Pain Osgood Schlatter disease Focal at the tibial tubercle

Etiology of Anterior Knee Pain inflammatory arthritis (RA, gout & pseudogout) [Diffuse + swelling and inflammatory change ] septic arthritis patellofemoral syndrome (Bilateral ) advanced osteoarthritis (Bilateral ) large knee effusions & injury to the quadriceps Plicae

Etiology of Popliteal Knee Pain Post Cruciate trauma Post Capsular trauma Tibial Neuritis Baker's cyst Synovitis Meniscal abnormalities Inflamation of any of post tendons

Etiology of Lateral Knee Pain & Lateral joint line pain Lateral compartment osteoarthritis injuries to the lateral collateral ligament lateral meniscal tears

Etiology of Lateral Knee Pain Iliotibial Band Friction Syndrome or Runner's knee Pain on the outer side of the knee