Knee | Notion

The table below summarises the key features of common knee problems:

Condition	Key features
Chondromalacia patellae	Softening of the cartilage of the patellaCommon in teenage girlsCharacteristically anterior knee pain on walking up and down stairs and rising from prolonged sittingUsually responds to physiotherapy
Osgood-Schlatter disease(tibial apophysitis)	Seen in sporty teenagersPain, tenderness and swelling over the tibial tubercle
Osteochondritis dissecans	Pain after exerciseIntermittent swelling and locking
Patellar subluxation	Medial knee pain due to lateral subluxation of the patellaKnee may give way
Patellar tendonitis	More common in athletic teenage boysChronic anterior knee pain that worsens after runningTender below the patella on examination

Referred pain may come from hip problems such as slipped upper femoral epiphysis

Patella fracture

Quadriceps tendon inserts at the superior pole of the patella and wraps distally around the patella to become the patellar tendon which inserts at the tibial tuberosity.

S/S of fracture

acute swelling, tenderness, inability to extend the knee against gravity, and a palpable gap in the extensor mechanism. However, patients with intact medial and lateral retinaculum may have partially spared knee extension.

Ottawa Knee Rules

To Consider a knee X-ray serires after trauma

Age 55 or older
Isolated patella tenderness
Tenderness at the head of fibula
Inability to flex at 90 degrees
Inability to bear weight immediately after trauma or in the ED for 4 steps (unable to transfer weight twice onto each lower limb regardless of limping)

Patellofemoral Syndrome

(runner's knee)

anterior knee pain secondary to trauma

symptoms are worse just after starting to walk after having been seated for a prolonged period. It improves after walking