Assessing symptoms
The three key features when addressing a patient with a knee problem are:
- The main symptom: pain, swelling, locking or giving way
- Age of the patient
- Mechanism of onset of problem
Most patients with knee problems will present with one or more of four core symptoms or signs: pain, swelling, locking and giving way. Each of these symptoms indicate specific types of problems leading to further questioning looking for a particular scenario.
Younger age is more likely to indicate a traumatic injury or anterior knee pain whereas older age usually indicates an arthritic wear and tear process.
Onset associated with trauma indicates specific injury to the knee anatomical structures where as gradual onset over time indicates a degenerative process.
Summary of History
After taking the history then there should be a fairly good idea of the diagnosis or, if not likely diagnoses, then the main category of problem.
Essentially the patient will be in one of four main categories:
- Anterior knee pain
- Traumatic injury to knee ligaments, meniscus or other structures
- Degenerative osteoarthritis
- Inflammatory joint problem