$Unique_ID{PAR00114}
$Pretitle{}
$Title{Medical Advice:  Knee Pains}
$Subtitle{}
$Author{
Editors of Consumer Guide
Chasnoff, Ira J}
$Subject{Knee Pains Tenderness pain Swelling leg straightening swollen joint
femur thighbone tibia shinbone fibula patella kneecap rheumatoid arthritis
Osgood-Schlatter disease tibial tuberosity chondromalacia x-ray examination
knees hips arthrogram}
$Log{
Knee Anatomy*0011401.tif}

Your Child:  A Medical Guide


Knee Pains


     Quick Reference

     SYMPTOMS
     - Tenderness or pain
     - Swelling
     - Difficulty in straightening the leg

     HOME CARE
     - Home care for knee pain usually involves limiting the child's activity.
       However, the extent of the limitation depends on what is causing the
       pain.

     PRECAUTIONS
     - If the child's knee is swollen, or if the child cannot straighten the
       leg, a doctor should be consulted.  The child should be careful not to
       put weight on the knee until the doctor has diagnosed the cause of the
       swelling.
     - Treatment for most types of knee pain involves limiting the child's
       activities.
     - Knee pain may indicate a hip problem.


     The knee is the most structurally complicated joint in the body.  Four
bones come together at that site:  the femur (thighbone), the tibia
(shinbone), the fibula (the small outer bone of the lower leg), and the
patella (kneecap).  Other important structures include two crescent-shaped
pieces of cartilage (elastic, semi-hard tissue) and two crossed ligaments (the
tough connective tissues that hold bones together).
     Because of its complexity, the knee is subject to a wide variety of
injuries and disorders--ranging from rheumatoid arthritis (the form of
arthritis that occurs most commonly in children) to puncture wounds that occur
during play or sports activity.  The knee can also be the seat of pain without
being the site of the actual problem; a hip condition can show up as a pain in
the knee.
     Active adolescents are subject to Osgood-Schlatter disease, a painful and
tender swelling of the bony prominence, called the tibial tuberosity, at the
upper end of the shinbone.  The leg is straightened when the large muscle at
the front of the thigh pulls (via the kneecap) on this tuberosity.  If an
injury cuts off the blood supply to the tuberosity, it becomes swollen and
tender, and straightening the leg causes pain.

     SIGNS AND SYMPTOMS

     Tenderness without swelling at the edges of the kneecap usually indicates
that the cartilage on the underside of the kneecap has been bruised and
softened (a condition called chondromalacia).  Swelling of the knee joint (as
evidenced by fullness on both sides of the kneecap) indicates inflammation in
the joint or an internal injury.  Diagnosing the cause of knee pain depends on
the patient's history, the presence or absence of symptoms, and the location
of pain.

HOME CARE

     Treatment depends on the problem, but usually (as in Osgood-Schlatter
disease and chondromalacia) it involves limiting the child's activities,
particularly strenuous activities like track, trampoline, football, and
soccer.  For two to four weeks, or until the swelling and tenderness are gone,
the knee must not be bent or extended.  From the child's point of view, this
rules out two-legged stair climbing, bicycling, running, and jumping.  An
elastic knee support can be a helpful reminder that the knee needs rest during
this period of healing.

PRECAUTIONS

  -  Swelling of the knee joint may be serious; it requires a doctor's
     attention.
  -  If one knee cannot be straightened to match the opposite knee, fluid
     (blood or the serum that remains after blood has formed a clot) or pus
     has probably accumulated at the joint.  The knee should be checked by a
     doctor.
  -  The child should not put weight on a swollen knee until it has been
     examined by a doctor.
  -  Remember that knee pain may be a sign of a hip problem.

MEDICAL TREATMENT

     The doctor will make a thorough, detailed examination of each part of the
knee and leg and will check the range of normal and abnormal movement.  The
doctor may order an x-ray examination of the knees and hips or an arthrogram
(a special x-ray study obtained after the injection of a special opaque fluid,
so as to outline the interior of the joint).  Swelling, accumulation of fluid,
and distortion or injury of parts of the joint may then be seen.  The doctor
may also order tests of fluid drawn from the joint.  Depending on the
diagnosis, treatment of knee pain may include bed rest, antibiotics, a cast,
crutches, or surgery.

RELATED TOPICS:  Arthritis; Hip problems; Puncture wounds; Sprains and
dislocations