question?- constant deep knee pain

[cute sara]

hi everyone

if a 55 years old man had medial constant deep knee pain and anterior intermittent ache knee pain and he experinced stiffness all around the knee which structures in the knee are responsible for each symptoms?

[physio99]

hi,
could you tell me if his lifestyle is active or sedentary.is he obese? i think i that there should be diffuse degenerative changes in the knee joint.does he have stiffness only in the morning or through the day? is there swelling, tenderness or redness around the joint line? what activity does aggravate the pain?

[physiobob]

Originally Posted by cute sara

hi everyone

if a 55 years old man had medial constant deep knee pain and anterior intermittent ache knee pain and he experienced stiffness all around the knee which structures in the knee are responsible for each symptoms?

Are you a student? This sounds like a homework question. You should know what structure cause discomfort and they are many! You should also present more of a clinical history and examination findings if we are to answer you directly. This could be anything from your description from a subchondral bone cyst to a referral from the lumbar area. More detailed information would be a help.

[cute sara]

hi

he worked full time as painter and decorator and he climbs up and down stair and squats and kneels down . in the past when was playing squash he had suden onset of knee pain and he underwent athroscopy and part of his cartilage was removed.
his present complaint: before 4 months he was playing football for 20 minutes and when kick the ball the knee was sore but he was able to continue playing and in the next morning the knee was stiff and sore on the medial side of the knee and medial knee pain was increasing. before 2 months the anterior knee pain and giving away present. x-ray taken before 2 months showed mild degenerative changes in right knee.
I think that structure involved in
medail pain : menisci and bone
anterior pain: quadriceps muscle weakness( i was thinking that this pain can be refer to menisci tear but when they did the menisci test the medail pain presented but anterior pain did not)

can deep pain related to muscles??????
can you help be becaue i am really confused

[linbin]

hi sara
a bit more info is needed
24hr behaviour of pain
aggravating and relieving factors
examination findings in detail
whether while doing movement is it a through range pain or end range pain
end feel
response to isometrics of knee flexors,extensors,tibial rotators
medial joint paincauses i suspect from your discription)
medial meniscal tear
medial collateral lig injury
loose body in the knee
pes anserinous strain

anterior knee paincauses)
ACL injury
patellar lig inj
arthrogenic pain inhibition of quadriceps

[cute sara]

hi
Thank you for your participation and this file include information about the patient

[linbin]

hi
the assessment you attached is a good one.i would like to know whether there is any full ness and tenderness in the popleteal fossa?any lab studies and x ray taken to rule out patellofemoral arthritis,cppd ,popleteal cyst.

[cute sara]

Hi

Thank you for your reply

The patient have tendrness over medial TFJ line no thickening and also tenderness of all marigins of PFJ and on compression of PFJ.( what this indicate?????)

The X-ray of the right knee showed mild degenartive changes in right TFJ medially, mild loss of joint space medailly and minor osteophytic changes medially , right PFJ NAD.

[linbin]

hi
sorry for the delay in replying.
the joint spae reduction might be due to osteoarthritis.i hope 45 degree angles xray on the right angled knee is taken to rule out pfj disorder.
if pfj compression test is positive then articular cartilage destruction should be considered.how.s the patellar tracking? quadriceps isometrics at multiple angles?