Knee pain is one of the most common reasons for patient visits to orthopedic, physiatrist, primary care and sports medicine offices. Most books that cover this topic review it as a chapter within a larger book on orthopedics as a whole, or they focus on one specific aspect of knee pathology, such as osteoarthritis.
This practical text is an evidence-based, user-friendly review of the literature for the breadth of knee pathologies that present to the busy practitioner. Opening with a review of the relevant anatomy, subsequent chapters discuss injuries to ligaments and tendons, the meniscus, and osteoarthritis. Additional chapters cover knee pain in the pediatric patient, sports trauma and fractures, and rheumatologic and infectious disease considerations. And while reviewing pathology and its diagnosis and treatment is important, proceeding through real case studies is extremely valuable in bringing the diagnosis and treatment of knee pathologies to life, hence an engaging section of clinical case material rounds out the presentation.
Taken together, A Case-Based Approach to Knee Pain will be an ideal resource for musculoskeletal medicine practitioners of all types.
Author(s): Michelle Leong, Grant Cooper, Joseph E. Herrera, Peter Murphy
Publisher: Springer
Year: 2022
Language: English
Pages: 336
City: Cham
Foreword
Acknowledgments
Contents
1: Knee Anatomy
Introduction
The Anterior Knee
Anterior Knee Joints
Extensor Mechanism
Articular Cartilage and Capsular Ligaments
Ligaments of the Anterior Knee
Posterior Knee
Popliteal Fossa and Posterior Knee Structures
Lateral Knee
Medial Knee
Bony Anatomy
Connective Tissue
Other Important Structures
Neurovascular Structures
References
2: Ligament Injuries
Anterior Cruciate Ligament
Pathology
Clinical Presentation
Physical Exam
Diagnostic Studies
Treatment
Return to Activities
Posterior Cruciate Ligament
Pathology
Clinical Presentation
Physical Exam
Diagnostic Studies
Treatment
Return to Activities
Medial Collateral Ligament
Pathology
Clinical Presentation
Physical Exam
Diagnostic Studies
Treatment
Return to Activities
Lateral Collateral Ligament
Pathology
Clinical Presentation
Physical Exam
Diagnostic Studies
Treatment
Return to Activities
References
3: Meniscus Injuries
Pathology
Clinical Presentation
Physical Exam
Inspection
Range of Motion
Palpation
Strength Testing
Provocative Maneuvers
Ligamentous Injuries
Thessaly Test
McMurray Test
Apley Grind Test
Bounce Home Test
Steinmann Part 1 Test
Diagnostic Studies
Plain Radiographs
Magnetic Resonance Imaging
CT Arthrography
Ultrasound
Arthroscopy
Treatment
Return to Activities
Rehabilitation for Nonoperative Patients
Rehabilitation Following Surgery
References
4: Osteoarthritis of the Knee
Introduction and Pathophysiology
Risk Factors
Clinical Presentation
Physical Exam
Diagnosis
Treatment
References
5: Patellofemoral Pathologies
Introduction
Patellofemoral Pain Syndrome
Clinical Presentation
Physical Exam
Diagnostic Studies
Treatment
Return to Activities
Idiopathic Chondromalacia Patellae
Clinical Presentation
Physical Exam
Diagnostic Studies
Treatment
Return to Activities
Patellar Tendinopathy
Clinical Presentation
Physical Exam
Diagnostic Studies
Treatment
Return to Activities
Patellofemoral Osteoarthritis
Clinical Presentation
Physical Exam
Diagnostic Studies
Treatment
Return to Activities
Prepatellar and Superficial Infrapatellar Bursitis
Clinical Presentation
Physical Exam
Diagnostic Studies
Treatment
Return to Activities
Lateral Patellar Compression Syndrome
Clinical Presentation
Physical Exam
Diagnostic Studies
Treatment
Return to Activities
Patellar Instability
Clinical Presentation
Physical Exam
Diagnostic Studies
Treatment
Return to Activities
Patellar Tendon Rupture
Clinical Presentation
Physical Exam
Diagnostic Studies
Treatment/Return to Activities
Patella Fracture
Clinical Presentation
Diagnostic Studies
Treatment/Return to Activities
References
6: Pediatric Knee Pain
Introduction
Life-Threatening
Septic Arthritis
What Is the Pathology, How, Why?
Clinical Presentation
Physical Exam
Diagnostic Studies
Treatment
Return to Activities
Osteomyelitis
What Is the Pathology, How, Why?
Clinical Presentation
Physical Exam
Diagnostic Studies
Treatment
Return to Activities
Malignancies
Osteosarcoma
What Is the Pathology, How, Why?
Clinical Presentation
Physical Exam
Diagnostic Studies
Treatment
Return to Activities
Inflammatory Conditions
Inflammatory and Systemic—Juvenile Idiopathic Arthritis (JIA)
What Is the Pathology, How, Why?
Clinical Presentation
Physical Exam
Diagnostic Studies
Treatment
Return to Activities
Lyme Arthritis
What Is the Pathology, How, Why?
Clinical Presentation
Physical Exam
Diagnostic Studies
Treatment
Return to Activities
Congenital or Developmental Abnormalities
Osgood–Schlatter Disease
What Is the Pathology, How, Why?
Clinical Presentation
Physical Exam
Diagnostic Studies
Treatment
Return to Activities
Osteochondritis Dissecans
What Is the Pathology, How, Why?
Clinical Presentation
Physical Exam
Diagnostic Studies
Treatment
Return to Activities
References
7: Outpatient and On-Field Evaluation of Sports Trauma in the Knee
Introduction
The Scope of This Chapter
Principles in the Management of Sports Trauma in the Knee
Categories of Musculoskeletal Injury
Initial Management of the Suspected Acute Musculoskeletal Injury
Mechanism
Initial Examination of the Knee [4]
Return-To-Play
Dislocations and Acute Reduction
Principles of Immobilization
Follow-Up and Continuing Evaluation
General Principles in Outpatient Management
Contusions and Sprains
Complete Soft Tissue Injuries About the Knee
Fractures
Open Fractures
Initial Management of Closed Fractures
Exceptions
Conclusion
The Outpatient Management of Traumatic Sports Knee Injuries
Introduction and Scope
Sports and Injuries Included
Organization
American Football
Mechanisms and Injuries
Direct Impact, Collateral Ligament, and Posterior Cruciate Ligament Injuries
Knee Dislocation
Collateral Ligament Injuries
Posterior Cruciate Ligament (PCL) Injury
Patellar Dislocation and Medial Patellofemoral Ligament (MPFL) Injury
Twisting Mechanisms, Anterior Cruciate Ligament and Meniscal Injuries
Anterior Cruciate Ligament (ACL) Injury
Meniscal Injuries
On the Field
Outpatient Evaluation
Knee Examination
Radiographic Evaluation
Management
When to Refer to a Surgeon
Initial Non-Surgical Management
Return to Sport
Basketball
Mechanisms and Injuries
Jumping, “Jumper’s Knee” and Quadriceps and Patellar Tendon Rupture
Pivoting and Ligamentous or Meniscal Injury
Anterior Cruciate Ligament (ACL) Injury
Meniscal Injuries
On the Field (Court)
Outpatient Evaluation
Knee Examination
Radiographic Evaluation
Management
When to Refer to a Surgeon
Initial Non-Surgical Management
Return to Sport
Ski
Mechanisms and Injuries
Anterior Cruciate Ligament Injury
Alpine Skiing and the Collateral Ligaments
High-Energy Collision, Knee Dislocations, and the Multi-Ligamentous Knee Injury
On the Slopes
Outpatient Evaluation
Knee Examination
Radiographic Evaluation
Management
When to Refer to a Surgeon
Initial Non-Surgical Management
Return to Sport
Soccer
Mechanisms and Injuries
Pivoting and Cutting: ACL and Meniscal Injuries
On the Pitch
Outpatient Evaluation
Knee Examination
Radiographic Evaluation
Management
When to Refer to a Surgeon
Initial Non-Surgical Management
Return to Sport
Summary and Conclusions
References
8: Knee Fractures
Basics of Fractures
Description of Fractures
Fracture Healing
Fracture/Displacement Types
What Needs Immediate Orthopedic Surgery Referral
Compartment Syndrome
Concern for Arterial Damage
Concern for Nerve Damage
Physical Examination for All Fracture Types
Phases of Rehabilitation
Common Fractures
Patellar Fractures
Overview
Clinical Presentation
Physical Exam
Diagnostic Studies
Treatment
Return to Activities
Patellar Dislocation
Overview
Clinical Presentation
Physical Exam
Diagnostic Studies
Treatment
Return to Activities
Tibial Plateau Fractures
Overview
Clinical Presentation
Physical Exam
Diagnostic Studies
Treatment
Return to Activities
Tibial Shaft Fractures
Overview
Clinical Presentation
Physical Exam
Diagnostic Studies
Treatment
Return to Activities
Proximal Fibular Fractures
Overview
Clinical Presentation
Physical Exam
Diagnostic Studies
Treatment
Return to Activities
Stress Fractures
Overview
Clinical Presentation
Physical Exam
Diagnostic Studies
Treatment
Return to Activities
References
9: Rheumatic and Infectious Causes of Knee Pain
Rheumatic Knee Pain
History
Crystalline Arthropathies
Gout
Calcium Pyrophosphate Deposition Disease (CPPD)
Rheumatoid Arthritis
Systemic Lupus Erythematosus (SLE)
Spondyloarthropathies
Inflammatory Bowel Disease-Associated Spondyloarthritis
Reactive Arthritis
Psoriatic Arthritis
Axial Spondyloarthritis
Sarcoidosis
Sjögren’s Syndrome
Adult-Onset Still’s Disease
Polymyalgia Rheumatica
Other Causes of Knee Pain (Table 9.4)
Tenosynovial Giant Cell Tumor
Synovial Chondromatosis
Infectious Knee Pain
Bacterial Arthritis
Specific Organisms and Population (Adults) [41]
Gonococcal Arthritis
Lyme Arthritis
Prosthetic Joint Septic Arthritis
Viral Arthritis
Hepatitis A
Hepatitis B (HBV)
Hepatitis C (HCV)
Parvovirus B19
Alphaviruses
Epstein–Barr Virus (EBV)
Varicella
Human Immunodeficiency Virus (HIV)
HIV-Associated Syndromes
Rheumatic Diseases with HIV Infection
SARS-CoV-2 Infection (COVID-19)
Fungal
Blastomycosis
Coccidioidomycosis
Cryptococcosis
Candida
Mycobacteria
References
10: Knee Pain Case Studies
Acute Burning Knee Pain
History
Differential Dx (Table 10.1)
Imaging
Bilateral Knee X-Ray
Diagnostic Discussion
Stages of Hemophilic Arthropathy
Management
Bleeding Reduction
Inflammation Reduction, Tissue Regeneration, and Pain Control
Knee Replacement
Areas of Research
Non-traumatic Knee Pain with Effusion
History
Differential Dx (Table 10.2)
Work Up: Imaging
Right Knee X-ray (AP View and Lateral View)
Diagnostic Discussion
Management
Areas of Research
Left Knee Swelling for 1 Month
History
Differential Dx (Table 10.3)
Work Up: Imaging
Diagnostic Discussion
Management
Patient Conclusion
Diffuse Knee Pain and Decline in Ambulation
History
Differential Dx (Table 10.4)
Work Up: Imaging
Diagnostic Discussion
Management
Patient Conclusion
Chronic Knee Pain in a 12-Year-Old
History
Differential Dx (Table 10.5)
Work Up: Imaging
Left Knee X-ray: AP Lateral View
Bilateral Knee X-ray: AP Merchant View
Diagnostic Discussion
Management
Areas of Research
Posterior Knee Pain
History
Differential Dx (Table 10.6)
Work Up: Imaging
Left Knee MRI (Fig. 10.13)
Right Knee MRI (Fig. 10.14)
Diagnostic Discussion
Management
Areas of Research
Knee Trauma After Motor Vehicle Collision
History
Differential Dx (Table 10.7)
Work Up: Imaging
Diagnostic Discussion
Management
Outcomes and Complications
Patient Conclusion
Knee Trauma from a Ski Crash
History
Follow-Up Physical Exam Findings
Right Knee
Special Exam Maneuvers
Differential Dx (Table 10.8)
Diagnostic Discussion
Work Up: Imaging
Right Knee Radiograph from Urgent Care (Fig. 10.20)
Right Knee MRI (Fig. 10.21)
Management
Areas of Research
References
Index
