When to Call the Doctor about Knee Pain

When you are deciding whether to call the doctor, a good rule of thumb exists for most long-term knee injuries. If your symptoms have not gone away after trying three to seven days of PRICE therapy and over-the-counter anti-inflammatory pain medications, you should set up an appointment with your doctor or a sports medicine or orthopedic (bone and muscle) specialist to further evaluate the pain. This rule can also be applied to new knee injuries that are not disabling. Any knee injury that makes it impossible for you to walk should be evaluated as soon as possible. Remember, however, that this rule should only serve as a guide. If you are concerned about the pain, you should call the doctor.

Many fractures may require immobilization in a specific position or surgery. Putting off seeing a doctor may hinder healing.

Other signs and symptoms that demand emergency evaluation:

  • Fever (which may indicate infection)
  • Unbearable pain
  • Drainage
  • Large wounds
  • Puncture wounds
  • Swelling, if you are on a blood thinner (war farin or Coumadin) or have a bleeding disorder
  • Swelling that is associated with redness and the knee feeling warm

The doctor will typically want to know the exact nature of the pain.

  • Where in the knee is your pain?
  • What does the pain feel like?
  • Has it happened before?
  • What makes it better or worse?
  • How long have you had pain in the knee?
  • The doctor will also want to know a bit about you.
  • Do you have any major medical problems?
  • How active is your lifestyle?
  • What are the names of the medications you are taking?

The doctor will want to know about any related symptoms.

Physical examination

  • The doctor will likely have you disrobe to completely expose the knee.
  • The doctor will then inspect the knee and press around the knee to see exactly where it is tender.

In addition, the doctor may perform a number of maneuvers to stress the ligaments, tendons, and menisci of the knee and evaluate the integrity of each of these. An experienced health care professional will be able to make a preliminary diagnosis based on this examination.

Both X-rays and CT scans are excellent for diagnosing fractures. They both are also poor, however, at evaluating soft-tissue structures of the knee such as ligaments, tendons, and the menisci. Magnetic resonance imaging (MRI) uses large magnets to create a three-dimensional image of the knee.

Fluid removal

The knee and all bursae of the knee are filled with fluid.If your symptoms suggest infection, inflammation, or certain types of arthritis, your physician may use a needle to remove fluid from the knee. The removal of the fluid will sometimes decrease the pain you have been experiencing and make it possible for you to bend your knee. This fluid will then be analyzed to better clarify the diagnosis and detect infection. Crystals, which suggest crystalline arthritis, often can be seen under the microscope.

Arthroscopy

The orthopedic surgeon may elect to perform arthroscopy if you have chronic knee pain. This is a surgical procedure where the doctor will place a fiberoptic camera within the knee joint itself. By doing so, the surgeon may be able to see small particles in the knee or to look more closely at damaged menisci or cartilage. The doctor may also be able to repair damage by shaving down torn cartilage or removing particles from the knee while the camera shows the inside of your knee.

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