How to Diagnose Medial Knee Pain
Of all the musculoskeletal conditions that orthopedists treat each year, knee pain remains one of the most common. Pain on the inside of the knee suggests the patient suffers from medial knee pain which can be tricky to diagnose. Initial X-rays may not reveal structural abnormalities typical of this kind of knee pain. A method for diagnosing medical knee pain is to understand how the patient's lifestyle may be contributing to the pain, perform an orthopedic physical examination and follow that with conservative treatment. If symptoms don't disappear, schedule an MRI to make the final diagnosis.
Instructions
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Record the patient's history of present illness. Note the patient's activities of daily living, paying special attention to whether the patient engages in sports or a recreational training program. For example, it would be important to know that a teenager complaining of knee pain reported that he or she participated in a military training program that involved hours of strenuous marching and jogging. Then ask if the patient recalls having twisted or injured the knee during this regimen.
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Find out when the knee pain first appeared, which most orthopedists consider before finalizing a diagnosis. See if this coincides with a recent injury, however minor. Then ask whether the patient had similar episodes of knee pain in the past and whether he or she sought treatment. For example, if the patient did have prior knee pain and had undergone an MRI, you would want to review the films from that study to pinpoint a diagnosis. You would also need those prior films to compare to any present films you might recommend.
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Perform a physical examination. Orthopedic surgeons suggest you should palpate the knee to determine whether muscle spasm or tenderness appears. Check for symptoms of internal knee derangement.
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Order X-rays of the knee and tibia. Examine the X-rays for evidence of musculoskeletal stress, ligament tears, soft tissue edema, knee joint effusion or any skeletal abnormalities.
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Test the patient's active range of motion in the knee using standard orthopedic tests. Have the patient flex and extend the knee to various angles. Check for symmetry and pain.
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Defer a diagnosis until after trying conservative treatment. Prescribe over-the-counter pain medications. Have the patient refrain from running, jogging, marching or doing any strenuous activity.
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Examine the patient after five to ten days of limited physical activity. Repeat the physical examination to see if the areas of tenderness have decreased or disappeared. Repeat the range of motion studies to see if the patient is able to flex and extend the knee without reporting pain.
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Determine the next step if the patient continues to report pain after the conservative treatment. Order an MRI of the knee. MRIs allow you to view the pathology of the pain with greater specificity than other X-rays or bone scans.
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Review the MRI report. If the test found a stress fracture in the area surrounding the proximal tibia, you may conclude that the patient suffers from medial knee pain.
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