Pain in the knee ( knee ) - Causes, Symptoms and Treatment .MF .
The knee joint is the most vulnerable joint - primarily because of its complex structure and conferred upon him loads.Orthopedics and Traumatology daily faced with a large number of patients complaining of pain in the knee in extension, at rest or while walking.
Causes of knee pain is not caused by disease
Vascular pain lap arise due to the deterioration of blood circulation knee.They usually begin in adolescence, the period of active growth - since the development of blood vessels in growing adolescents often does not have time for the accelerated growth of the bones.But their intensity after 18-20 years usually decreases (and not increases with age, as is the case with arthritis), are not accompanied by a decrease in the mobility of the knee.Pain is usually symmetrical.
diseases that accompanies the pain in his knee
diseases in which there is pain in the knee, are very diverse, due to the complexity of the structure and function of the knee.Damage to the knee can affect any of the ligaments, t
bruise in the knee area characterized by a limited hemorrhage in the soft tissues in the joints, swelling and local tenderness, impeding movement.As a result of injury to the tissues is disturbed microcirculation.Damage to blood vessels and nerve endings causing varying degrees of bleeding, swelling and pain.
Traumatic hemarthrosis of the knee joint, or bleeding into the joint cavity, develops as for bruises, and in more severe joint damage;usually accompanied by damage to the meniscus, ligaments, capsule, bone.When hemarthrosis streamed blood affects the synovial membrane, causing its swelling and edema of synovial villi, which, in turn, begin to produce excessive amounts of synovial fluid.By the nature of the remote exudate can judge the location and severity of damage to the intra-articular structures.If the punctate blood predominates, it can be assumed rupture of the synovial membrane, a cruciate ligament, medial meniscus injury in prikapsulyarnoy zone.If the damage of the articular cartilage and menisci transkhondralnom rupture of blood in the joint is usually not.For bone lesions are characterized by a joint with drops of blood fat.Removing blood from the joint and washing it is recommended for the prevention of chronic serous-fibrinoid synovitis, when a lot of exudate fibrin precipitated in the form of individual fibers and clots, which can grow blood vessels to form a semi-free naps.
rupture ligaments (full or partial).Damage to the external lateral ligament of the knee occurs less frequently than internal, and occurs when an excessive deviation of the lower leg medially (for example, tucking his feet).The gap is often complete, it can be combined with a tear fracture of the head of the fibula.The patient complains of pain in the area of damage that increases with deviation inwards shin.Movement is limited.Joint otёchen determined hemarthrosis.Severity of symptoms depends on the degree of damage to the knee ligaments.In a complete break is detected looseness (excessive motility) in the joint.
Damage to the inner side of the knee ligament occurs more often, however, it is usually the damage is incomplete.Injury occurs when excessive deviation outwards shin.Break lateral ligaments is often combined with the internal meniscus rupture and damage to the joint capsule, which can be diagnosed during magnetic resonance imaging of the knee joint.The patient complains of pain on palpation, movements, deviation lower leg outwards, joint otёchen.Reveals hemarthrosis.Movement is limited.Complete rupture is accompanied by excessive mobility in the joint.
When cruciate ligament rupture , which are located inside the joint, often hemarthrosis.Therefore, diagnosis of rupture of the ligaments in the acute period is very difficult, because when hemarthrosis is almost impossible to investigate the symptom of "drawer", characteristic of damage to the cruciate ligaments.To study this symptom should be back in 3-5 days or after a puncture of the joint and remove the blood.Treatment of cruciate ligament rupture operative.
damaged meniscus (meniskopatiya) - the most common of knee joint injuries, sometimes difficult to diagnose.Sudden unusual movement in the joint with turning hips with fixed feet and legs sometimes leads to detachment of the meniscus, or crush it between your bones.Quickly there hemarthrosis;It determined an important symptom of the blockade - the patient can not fully straighten your leg at the knee joint.This condition requires an immediate referral to the traumatologist to eliminate the blockade.Often joint blockade alone is permitted, hemarthrosis and resolves in 5-7 days and the patient, without recourse, he continues.Blockades are repeated, but each time the pain after the meniscus infringement and hemarthrosis become smaller.However, this is a very serious situation, as repeated infringement of the meniscus over time (within 1 year) lead to the development of deforming arthrosis and even then meniscectomy (removal of the meniscus) is ineffective.
Even with the slightest suspicion of a meniscus tear is required trauma counseling and joint X-rays.The latter is due to the frequent combination of meniscus injury with intra-articular fractures.
Chronic patellar dislocation (displacement of the kneecap) is relatively rare (0.4 - 0.7% of all dislocations), but often recur in the future.In the case of habitual dislocation in children usually formed gonycampsis age of valgus (X-shaped) deflection tibia and progressive na¬rushenie limb function.In most cases, the outer vozni¬kaet patellar dislocation, at least - the internal.Very rare dislocation of the patella, called torsion, in which the patella povorachivaet¬sya around its axis.Patients with chronic patellar instability disturbed pain in the front and the inner surface of the knee joint.They may complain of a feeling of instability, laxity in the knee.On examination, patients with special methods of determining the degree of displacement of the patella.Refines the diagnosis of X-ray examination.
Inflammation of the tendons (tendonitis). The causes of tendinitis are:
- significant physical load on the joint for a long period of time.
- infections caused by bacteria such as gonorrhea;
- the presence of rheumatic diseases (gout or arthritis);
- an allergic reaction to the medication;
- anatomical structure of the body: different length of limbs promotes the development of tendinitis of the knee;
- weakened tendon or misuse of their development;
- failure to comply with the correct posture.
most severe symptoms of tendonitis include pain and limited mobility.Pain at the site of inflammation and the surrounding areas of bearings, not long pass.The pain may appear suddenly, but sometimes pain increases as the inflammation increases.There is increased sensitivity at palpation of the affected tendon.
Bursitis - inflammation of periarticular bag (bursa), which contains washing the joint fluid.Common bursitis symptoms: redness, swelling, pain and tenderness over the kneecap, restriction of mobility in the joint.If bursitis let go in a state of chronic inflammation, there is a probability of occurrence of adhesions, from which it will be possible to get rid of only by surgery.
Synovitis - an inflammation of the synovial membrane that covers the inside of the joint cavity.This forms effusion, which accumulates in the joint capsule.Besides injuries synovitis may develop in a variety of autoimmune processes, with metabolic disturbances, on the background of existing diseases of the knee joint (gonarthrosis) inflammation may be of a secondary nature (reactive synovitis of the knee joint).Usually, inflammation is aseptic character (ie there is no infection) and shows the formation of serous effusion.If it joins the infection, the nature of the synovial fluid is changed, it appears pus and purulent synovitis develops.Symptoms appear gradually over several hours or even days after injury.The joint is increased in volume.Liquid as if bursting with intra-articular structures deforms the contours of the knee.Limited joint function, but a traffic violation is not always accompanied by pain.However, the pain is still typical for this disease, but it is not sharp and blunt, medium intensity.The skin over the joint is not hyperemic, not the temperature increased.
Baker's cyst - soft elastic dense tumor formation, developing on the back surface of the knee joint (in the popliteal fossa).The skin over the swelling of normal color, not soldered to the underlying tissues.Baker's cyst longer appears when unbent knee.When bending is reduced in size or disappear completely.The appearance of a Baker cyst is a consequence of any of the knee joint diseases, among which are the most common: joint injury, damage and degenerative changes in the menisci, cartilage damage joints, chronic synovitis (inflammation of the synovial joints), osteoarthritis, patellofemoral arthrosis, osteoarthritis, rheumatoid arthritis.Visually Baker's cyst is a dense elastic circular formation in the popliteal fossa, which can be seamlessly with your knees bent and quite clearly speaks during a joint unbent.In the popliteal region may be discomfort or pressure (and sometimes - and pain), difficulty or pain when moving the knee.With significant amounts of Baker cyst due to compression of adjacent blood vessels and / or nerve trunks can be skin cooling leg below the knee, a feeling of numbness, tingling, "pins and needles", swelling and other signs of circulation and innervation.Possible complications include the development of a cyst Baker thrombophlebitis and deep vein thrombosis shin, development or exacerbation of pre-existing varicose saphenous veins, and the severance of the cyst wall, reflected a sharp severe pain, reddening of the skin back of the leg, increased local temperature, swelling.
Hoff disease is damage and degeneration of the adipose tissue surrounding the knee joint.It is quite difficult diagnosable condition that is often confused with damage to the meniscus, so-called "joint mouse" - a fragment of cartilage or bone in the body joints.Without a competent treatment of the knee when the disease Hoff "fat pad" ceases to perform its function of a buffer - the disease becomes chronic, it increases the risk of knee osteoarthritis, can provoke persistent pain in the knee joint over the years.Most often, when a knee injury is damage to the fat lobules, their pinched, bleeding and swelling of tissues.In place of the damaged cells growing fibrous tissue that can not perform the functions of adipose tissue.In some situations Hoff disease can develop on the background of osteoarthritis knee or under the influence of hormonal changes, for example, women in menopause.In the acute stage of the disease damages the body fat can be diagnosed already at the examination.In addition to the pain in the knee, quadriceps weakness, a characteristic feature of palpation is localized swelling.But the chronic stage is not always easily defined - may need an MRI, CT scan or arthroscopy in the absence of response to conservative treatment.
Osgood - Schlatter (osteohondropatija tibial tuberosity).Often occurs after increased physical exertion or injury by pulling the patella ligament.It affects mainly teenage boys aged 13-15 years old, engaged in sports.Symptoms include pain, swelling in the tibial tuberosity.
Arthritis - inflammation of the joint, which most often occurs in diseases such as rheumatoid, reactive arthritis, psoriatic arthritis, as well as ankylosing spondylitis, rheumatism, gout.Features - joint pain, stiffness, limitation of joint mobility, swelling, fever in the field of destruction, deformation of the joint.
soft tissue swelling in arthritis
Deforming osteoarthritis - a disease of the joints characterized by lesions (thinning and destruction) of cartilage of joints with simultaneous deformation and changes in the bone structure of the head.In the early stages of arthritis manifests itself by symptoms such as pain, usually arising at the beginning of the movement after the standstill, and the pain pretty soon pass.With further progression of pain in motion amplified appear not only when driving, but at rest there is a feeling of stiffness of the joints, limiting their mobility.When the knee joint deforming arthrosis is a significant curvature of the legs, its axis deviation from a straight line, which leads to difficulty and the complete impossibility of joint work.Finally, in the last stages of arthrosis deformans lead to its complete destruction.To restore joint function, pain relief, limb length reduction is performed knee arthroplasty.
Severe osteoarthritis of the knee X-shaped limb deformity
Patellar chondropathy - a pathological condition characterized by degenerative and necrotic changes in the articular cartilage of the patella.There directly after the trauma of varying intensity, and on the background of chronic trauma, and especially when the lateral displacements of the patella.Patients complain of pain in the kneecap, which is enhanced by physical activity.Kneeling very painful even for a short time.Finding lower extremity in a bent position, such as when driving long in the vehicle, can also lead to the emergence of pain in the patella.When the movements of the knee can be heard crackling or clicking noises occur.
chondromatosis knee joint - long-term, progressive disease of unknown etiology, is the formation of multiple cartilaginous nodes inside the synovial membrane of the joint capsule.Cartilage nodes may have dimensions of several millimeters to several centimeters, and their number varies from individual formations few to several tens.appear moderate pain, there is a crunch and limited mobility in the limbs affected joint, swelling, and the formation of "joint mouse" With a significant amount of cartilage components or the formation of large-sized units - infringement.Can nastupt drastic disfigurement and significant limitation of joint function.
disease Koenig or cleaving (cutting off) the osteochondrosis (ostehondrit) - a disease in which the cartilage portion covering the bones gradually exfoliate and may even be completely separated from the bone.In the knee joint, it affects only the condyles of the femur and the patella (kneecap).Symptoms depend on the stage of the disease.At the beginning of the disease the patient complained of discomfort in the joint, minor pain.With the progression of the process, there has been increasing joint pain, synovitis appears.It may be incomplete separation of necrotic areas of cartilage, possible joint block (is caused by the separation piece of cartilage, resulting in disruption of joint work).Further areas of dead cartilage is completely separated from the bones, possible joint blockade of pain and progression of synovitis.If the disease is prolonged, the lameness reduces the range of motion in the knee joint, and atrophy of the quadriceps femoris.Patients can celebrate arthritis connection with the previous urogenital or intestinal infection.Disease begins with a melting of bone substance bone, or with significant necrosis of the skin, a process that eventually begins to extend to greater and greater area.Regardless of the initial manifestations of tuberculosis of bones and joints causes the formation of a fistula or purulent cavity, opening outwards.It should be noted that after a few weeks, the inflammatory process can be stabilized and the patient comes remission.At the beginning of the disease the person may complain of weakness and pain in the muscles.Then abruptly the temperature rises to 39-40 degrees.The pain is clearly localized in the affected bone area, there is almost at once.Acute, boring or arching inside, aggravated by the slightest movement - such pain is difficult with something confused.
therapists Kletkina Y.