Causes of Knee sprain
Knee sprain Causes: Book Excerpts
Related information on causes of Knee sprain:
As with all medical conditions,
there may be many causal factors.
Further relevant information on causes of Knee sprain may be found in:
Causes of Knee sprain: Online Medical Books
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Knee Pain/Swelling:
Differential Diagnosis
(In a Page: Signs and Symptoms)
-
Degenerative joint disease (osteoarthritis)
-
Ligamentous injury
–ACL: Positive Lachman (more sensitive) and anterior drawer test
–PCL: Positive thumb sign (more sensitive) and posterior drawer test
–MCL: Pain and/or increased laxity with valgus stress
–LCL: Pain and/or increased laxity with varus stress -
Meniscus tear
–Patient may complain of pain and locking; positive McMurray circumduction test
-
Patellofemoral syndrome
- Iliotibial band syndrome
–Pain along the lateral aspect of the knee accompanied by a palpable or audible snapping
–Occurs almost exclusively in runners
- Pes anserine bursitis
–Patients complain of pain along the medial aspect of the knee (at pes anserinus insertion)
–Caused by repetitive movement that creates an inflammatory response
-
Joint effusion
–May be secondary to osteoarthritis, inflammatory arthritis, ligament injury, gout, pseudogout, or infection -
Joint infection (septic joint)
–Staphylococcus aureus is most common
–Neisseria gonorrhoeae is common in
adolescents and young adults
–Salmonella is common in sickle cell patients
–Haemophilus influenzae is common in children -
Osteochondritis dissecans (OCD)
–Osteonecrosis of subchondral bone
–Most commonly seen in the knee
–Patient reports a gradual onset of pain
–Exam reveals tenderness of the affected
area with manipulation
-
In the pediatric population, consider Osgood-Schlatter disease, physeal injury, and discoid meniscus
-
Hip or foot/ankle disease with referred pain to the knee
-
Malignancy
-
Osteomyelitis
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Knee Pain:
Differential Diagnosis
(In A Page: Pediatric Signs and Symptoms)
- Septic arthritis
–Characterized by redness, swelling or effusion, warmth, pain with active and passive ROM, fever or chills
–Requires urgent evaluation and diagnosis
- Osgood-Schlatter disease (OSD)
–Repetitive microtrauma to the bone-tendon junction where patellar tendon inserts into the secondary ossification center of the tibial tubercle
–Onset at early adolescence, more often in athletes
- Sinding-Larsen-Johansson disease
–Similar to OSD, except localized to distal pole of the patella
- Meniscal pathology
–Meniscal tears are usually associated with acute trauma, and involve pain and swelling with mechanical symptoms such as popping, clicking, or locking
–Discoid meniscus: Mechanical symptoms and plain X-rays show squaring, widening, and cupping
- Ligamentous injury
–Medial collateral ligament sprain via overuse injury or valgus force to knee
–Anterior cruciate ligament tear associated with sport noncontact pivoting injury, associated with a “pop” and immediate swelling
–Posterior cruciate tear associated with direct trauma to anterior tibia or hyperflexion with plantar flexed foot
–Lateral collateral ligament injury is rare
-
Osteochondritis dissecans
–Trauma resulting in separation of subchondral bone and cartilage at lateral aspect of medial femoral condyle
-
Patellar subluxation/dislocation
–Lateral displacement of patella associated with increased Q angle, genu valgum, and femoral anteversion (more common in women)
-
Bursitis
–Chronic friction over pes anserine, iliotibial band, or capsular bursa leads to inflammation and thickening of the bursa
-
Bipartite patella
–Common variant of patellar ossification
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Acute Knee Pain:
Differential Overview
(Field Guide to Bedside Diagnosis)
❑ Osteoarthritis
❑ Patellofemoral pain
❑ Collateral ligament sprain
❑ Meniscal tear
❑ Anterior cruciate tear
❑ Infrapatellar quadriceps tendinitis
❑ Acute monoarticular arthritis
❑ Prepatellar bursitis
❑ Anserine bursitis
❑ Hamstring injury
❑ Baker cyst
❑ Septic joint
❑ Iliotibial band syndrome
❑ Hemarthrosis
❑ Patellar fracture
❑ Patellar dislocation
❑ Osteochondritis desiccans
❑ Osteonecrosis
» READ BOOK EXCERPT ONLINE »
Source: Field Guide to Bedside Diagnosis, 2007
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