Knee History

Groups of Knee Pain

Acute knee pain with history of trauma or overuse Atraumatic knee pain with effusion Atraumatic knee pain without effusion Referred pain Location based

History

• Mechanism
  • Trauma vs atraumatic sudden vs insidious
• Pain
  • Location and character
    • Any neuropathic qualities?
  • Pattern
    • Inflammatory arthropathy – morning stiffness, rest pain, relief on movement
    • Mechanical – pain on weightbearing, worse later in day
  • Severity – although limited clinical utility
• Swelling – immediate vs delayed?
• Locking, giving way, instability – internal derangement
• Snapping - consider ITB, pes anserine tendons

• Constitutional symptoms – fever, night sweats, weight loss, rash
• Back pain?
• Other joint involvement

• Previous injuries and treatments
• Medical history – any systemic or rheumatological disease?
• Occupation and hobbies/sports
• Training history

• Possible differential based on history of trauma
  • Flexion, rotation, compression: meniscus
  • Valgus force: MCL
  • Sudden deceleration or change in direction with planted/fixed foot: ACL
  • Landing on flexed knee or MVA with posterior force to tibia: PCL
  • Force to anteromedial extended knee or external rotation and hyperextension: posterolateral corner injury
  • Swelling in knee with occasional locking and clicking: meniscus or loose body
  • Pain on prolonged knee flexion, during squats, up and down stairs: PFS
  • Anterior knee pain jumping and on full flexion: patellar tendinitis, PFS