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The Table below summarises several conditions that can cause mechanical knee pain:
Symptoms
Signs
Management
Referral
Patellofemoral pain
Pain.
Worse with activity.
Pain or crepitus on patellar tracking.
Genu valgum.
Hypermobility.
Positive Clarkes test.
Pronated forefeet.
Access Biomechanics and muscle balnce.
Activity modification.
Physiotherapy.
Patella Dislocation.
Dislocated patella.
Reduction of patella, Mobilisation.
Physiotherapy, Orthopaedics if recurrent dislocation.
Osgood Schlatter's disease.
Pain on activity.
Pain on resisted extension.
Tender (+/- swollen tibial tuberosity).
Ice.
Sinding-Larsen Johannsson disease.
Pain lower pole patella.
Tender lower pole patella.
Worse on extension.
Plica syndrome.
Pain on flexion.
May be tenderness.
NSAIDs, activity modification.
Osteochondritis dissecans.
Pain, Locking.
Weakness.
May be normal.
Analgesics.
Orthopaedics.
Loose body.
Pain, Locking
Giving way
Swelling
Tenderness, effusion, joint restriction.
NSAIDs.
Yes – may need arthroscopic removal of loose body.
Haemarthrosis.
Swelling (soon after injury).
Large, tense effusion.
Hamstring spasm.
May need MRI / aspiration.
Fat Pad impingement.
Pain, Swelling.
Pain when knee extended.
Physiotherapy, Orthopaedics if severe or causing functional limitation.
Meniscal Injury
Locking.
Giving way.
Swelling.
Positive McMurray's test.
MRI to confirm.
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