DIAGNOSIS OF ATRAUMATIC KNEE PAIN

Abstract

Knee pain is one of the most common reasons for seeking advice for musculoskeletal pain. The purpose of this article is partly to provide an overview of the research conducted in the field of atraumatic and degenerative knee pain and partly to evaluate whether conventional testing and treatment practices are consistent with this research.

This article is based on a selection of English-language studies on atraumatic and degenerative knee pain found through a Medline search , hand search of reference lists of articles, and literature suggested by Mendeley . Preference was given to studies of gonarthrosis , degenerative meniscal injuries, and the psychosocial context of knee pain.

There is often little agreement between diagnostic imaging findings and clinical presentation, and extra-articular origin can easily be overlooked. Typically, symptomatic gonarthrosis can be diagnosed clinically. If there is a need for diagnostic imaging, standing x-rays are the first choice. MRI is often used uncritically in cases of suspected arthrosis or meniscal injury, but this examination rarely provides clinically useful information. Physical activity-based forms of treatment produce results that are at least as good as arthroscopic surgery for degenerative knee pain and should be the first choice. Atraumatic knee pain is often associated with psychosocial problems, especially in cases where clinical and radiographic findings are poor.

Many patients with knee pain receive testing and treatment that is inconsistent with recent research. Both patient and society will be better served by a more evidence-based approach.