Acute knee pain

introduction

The knee joint is generally very susceptible to injuries and discomfort. Due to the high weight load caused by body weight alone, as well as the strain in many sports, knee problems and acute knee pain are not uncommon. Acute pain often occurs suddenly and is usually triggered by excessive stress or an accident.
Here you will first find an overview of non-accident-related causes of current knee pain. Causes directly caused by accidents can be found at the corresponding point below in the text.

Not accident-related causes

The non-accident-related causes of acute knee pain include:

• Rheumatic diseases
• Activated osteoarthritis
• Attack of gout
• Psoriatic arthritis
• Patellar tip syndrome
• Plica syndrome
• Lyme disease

In the following you will find a brief informative description of the respective clinical picture.

Causes from the rheumatic group of forms

The term "rheumatic form" includes numerous different diseases that cause pain and limitations in the human musculoskeletal system. Rheumatic diseases can be autoimmune, wear and tear or metabolic-related or have numerous other causes.

Inflammatory diseases such as arthritis are just as much rheumatic as the chronic damage caused by osteoarthritis. The knee is particularly often affected by osteoarthritis, joint inflammation, gout, tendinitis or connective tissue diseases. The therapies are as varied as the diseases are. While some diseases can be adequately treated with physical therapy, autoimmune-related diseases often require the prescription of immune suppressing drugs.

Is your knee pain aching and localized in the hollow of the knee? Then find out more about:

• Pulling in the hollow of the knee - is that dangerous?

Activated osteoarthritis

Osteoarthritis is a chronic and irreversible disease of a joint. The knee joint is often affected by osteoarthritis. Obesity, strenuous sports, previous damage from injuries, operations and old age are the main contributors to the development of osteoarthritis. The articular cartilage can wear out and become narrower through years of stress. It cannot recover, which is why the osteoarthritis can only be stopped therapeutically.

In an advanced stage of the disease, the joint surfaces experience so much stress that it can lead to signs of inflammation with redness, swelling, restricted mobility and pain. This is called activated osteoarthritis. The so-called "starting pain" at the beginning of a movement is typical. After a short time, the pain can appear even at rest. The activated osteoarthritis often alternates with the dormant osteoarthritis, which is characterized by a subsiding of the inflammation and a decrease in symptoms.

Read more on the topic: Knee osteoarthritis

Appointment with a knee specialist?

I would be happy to advise you!

Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)

The knee joint is one of the joints with the greatest stress.

Therefore, the treatment of the knee joint (e.g. meniscus tear, cartilage damage, cruciate ligament damage, runner's knee, etc.) requires a lot of experience.
I treat a wide variety of knee diseases in a conservative way.
The aim of any treatment is treatment without surgery.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

You can find me in:

• Lumedis - your orthopedic surgeon
  Kaiserstrasse 14
  60311 Frankfurt am Main

Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
Further information about myself can be found at Dr. Nicolas Gumpert

Attack of gout

A sudden attack of gout can be a common cause of acute and extremely painful knee problems. Attacks of gout are widespread among the population and can cause pain in various joints. This is due to an increased uric acid level, which can occur due to metabolic processes or through one-sided and improper nutrition.

Uric acid can be compensated and dissolved to a certain extent in the blood. On the other hand, with increased amounts, the body forms uric acid crystals from the excess acid, which circulate in the body and can settle in joints. In most cases, the metatarsophalangeal joint of the big toe is affected, but the knee is not a rare location either.

In addition to intense, acute pain, swelling, lump formation, fever, nausea and itching can occur. The uric acid levels can be lowered with medication in an acute attack, but in the long term the diet should be switched to low-purine food.

Read more on the topic: Attack of gout

Psoriatic arthritis

Psoriasis is a chronic skin disease. It is also known as psoriasis. Psoriasis is primarily noticeable as inflammatory, red, itchy flakes of the skin. However, a complication of this skin condition can be arthritis (joint inflammation). This so-called "psoriatic arthritis" is noticeable as a painful and progressive joint inflammation that can affect all small and large joints in the body.

In addition to the knee, the spine is also often affected. If left untreated, joint inflammation can lead to protracted pain, restricted mobility, stiffening of the joints and thus a massive impairment of the quality of life. As a cause of acute knee pain, psoriatic arthritis is a rather rare disease, but diagnostically it should be considered in the long term.

Read more on the topic: Psoriatic arthritis

Patellar tip syndrome

In common parlance, the patella is often only meant to refer to the kneecap, but the tendon of the quadriceps muscle that extends over the kneecap and is involved in stretching the knee is also called the patellar tendon. The patellar tendon starts at the upper area of ​​the shin and therefore just below the knee. Certain movements, sports or excessive strain on the knee joint can lead to chronic irritation of the tendon at its base on the shin. This can cause the tendon to react inflammatory and lead to swelling, redness, pain and restricted mobility.

In particular, sports that have to do with rapid acceleration, deceleration and jumps are predestined for patellar tip syndrome. The most important therapeutic measure is to protect the knee joint and to reduce long-term, highly stressful movements.

Read more on the topic:

• Patellar tip syndrome
• Patellar tendinitis

Plica syndrome

The so-called "plica" is a small part of the inner joint capsule that arises during human embryonic development and divides the knee joint into two areas. Normally the plica regresses in childhood, but parts can often remain that are below the knee slide in the middle of the joint.

Often these plica residues do not cause any complaints, but complaints can occur during particularly stressful sports activities. The plica can even rub so hard on the cartilage that, in the long term, there is early joint wear. The current inflammation can subside with a rest, but in the long term only a short operation as part of a jointoscopy can help.

Read more on the topic: Plica syndrome

Lyme disease

Borreliosis is a bacterial disease that, if left untreated, can be associated with various different clinical pictures. The Borrelia causing this are mainly transmitted by tick bites. Initially there is a very typical so-called "wandering redness" around the puncture. A red circle forms around the stitch, which slowly migrates outwards and becomes larger.

Typical diseases that can be triggered by Lyme disease are skin nodules, inflammation of the myocardium, infestation of the meninges and cranial nerves, skin diseases and joint inflammation. In so-called "Lyme arthritis", which occurs after a few weeks to months at the earliest, the inflammation can affect several joints or just one joint. The knee is very often affected. There is inflammation of the synovial fluid and swelling of the knee joint. Acute pain can vary and fluctuate.

Read more on the topic: Burning in the knee

Accident-related causes

The causes of acute knee pain that are directly triggered by accidents include:

• Joint effusion
• Hofftitis
• Free joint body
• Acute Baker's cyst
• Hematoma in the knee
• Cruciate ligament tear
• Meniscal tear
• Lateral ligament tear (inner / outer ligament)
• Broken bone
• Kneecap dislocation
• Runner's knees

You might also be interested in this topic: Cruciate ligament overstretched

Below is a brief informative description of the respective clinical picture.

Joint effusion

An effusion in the knee joint can have various causes, dimensions and symptoms. First of all, the word “effusion” describes an accumulation of fluid that can be formed from water, pus or blood. This is often due to effusions from inflammation of the joint or after irritation from free joint bodies, Baker's cysts or plica syndrome. Gout can also cause fluid to build up after the crystals have deposited.

Read more on the topic: Water in the knee

On the other hand, there are bloody joint effusions that occur after various injuries to the knee. In the first place, the underlying disease that led to the joint effusion must be treated therapeutically. Large effusions can also be punctured with a needle. In this way, on the one hand, the diagnosis can be confirmed by examining the liquid, on the other hand, the effusion can also be relieved and the symptoms reduced. Smaller joint effusions in the knee can resorb themselves so that a puncture is not always necessary.

Read more on the topic: Joint effusion in the knee

Hoffitis

The name "Hoffitis" reveals that it is an inflammatory change in the Hoffa fat pad in the knee. The fat body lies below the kneecap and thus between the 3 bones connected in the knee joint. After minor accidents to the knee or without an apparent cause, the fat body can grow and swell. The body of fat changes, becomes inflammatory and coarse and can cause unpleasant pain and restricted mobility in the knee joint.

Free joint body

A free joint body is also known as a joint mouse. This means a structure that lies inside the knee joint, is freely movable and does not fulfill any function. These can be parts of the bone, cartilage, the joint capsule, but also other collections of tissue. A free piece of tissue in the joint need not cause symptoms, but depending on its location and size, it can cause extreme discomfort.

Some people affected can already feel severe pain in their knees during sport and everyday activities, which are caused by irritation of the joint structures. If the symptoms are too severe, the joint body can be removed with the help of a joint mirror.

Read more on the topic: Knee swelling

Acute Baker's cyst

A Baker's cyst can also be an underlying disease that is responsible for acute knee pain. A cyst is a fluid-filled bladder that can form in various parts of the body. Often, cysts can grow over the years and cause increasing discomfort.

Baker's cyst lies behind the knee joint in the hollow of the knee. It is often preceded by minor knee injuries or inflammations that cause the cyst to form for the first time. Especially when the knee is bent, it can lead to an uncomfortable feeling of pressure in the hollow of the knee, pain and tingling in the lower leg. Sustainable therapy for Baker's cyst is to repair the knee damage that caused it.

Read more on the topic: Baker's cyst in the knee

Hematoma in the knee

A hematoma in the knee is a special form of joint effusion. Blood accumulations always arise as a result of damage to smaller blood vessels inside the knee joint capsule. In most cases, this is due to an injury to the internal joint structures. The most common injuries of this type are meniscal tears, collateral ligament tears, cruciate ligament tears, knee fractures, and injuries to the kneecap.

Treatment begins with addressing the underlying injury. Larger effusions, however, often have to be punctured as well. A jointoscopy can also be performed if the knee has a bruise. However, subsequent interventions and operations on the knee can in turn cause hematomas. The hematoma itself can lead to severe pain and restricted mobility of the joint.

Read more on the topic: Ligament injury in the knee joint

Cruciate ligament tear

The human knee has 2 cruciate ligaments that stretch between the joint surfaces of the knee and are under great tension. They play a key role in the stability of the knee and inhibit the extension and rotation of the knee, as well as the mobility of the thigh to the lower leg.

Cruciate ligament tears occur mainly in sports accidents without external influence. The rapid rotation of the lower leg is often a typical force that tears a cruciate ligament. The acute knee pain after a cruciate ligament tear is mainly caused by the bruise and the tension in the joint capsule. The main symptom of the cruciate ligament rupture itself is often just instability in the knee.

Read more on the topic:

• Anterior cruciate ligament tear
• Posterior cruciate ligament tear

Meniscal tear

The menisci are cartilage discs that ensure stability in the joint, cushion movements and compensate for the uneven joint surfaces. The menisci of a knee, like the cruciate ligaments, can also tear in sports accidents or in rapid, abrupt movements. In order to fully diagnose the tear, a jointoscopy or an MRI must often be performed.

Similar to the cruciate ligament tear, the pain is mainly caused by the hematoma in the knee and the resulting increase in tension in the joint. This also significantly restricts mobility. During therapy, the benefits of an operation must be carefully weighed up. Meniscal sutures are possible but not always useful or necessary.

Read more on the topic: Meniscal tear

Collateral ligament tear

The so-called "collateral ligaments" are located on the inside and outside of every knee joint and ensure the lateral stability of the knee. A crack occurs as a result of strong lateral forces, inward or outward. In the following examination, if the outer ligament is torn, the knee can be folded outwards. The pain that follows is moderate and occurs mainly when the patient is exerted. As a rule, a collateral ligament only needs to be spared for a few weeks. Complete stability and recovery can only be expected after about half a year at the earliest.

Read more on the topic:

• External ligament tear on the knee
• Inner ligament tear on the knee

Broken bone

Fractures in the knee are comparatively rare. A bone fracture often only occurs as a result of direct, external violence, but more rarely also as a result of ligament tears that cause bone splintering. The most common causes of accidents are direct falls on the knee or car accidents. A fracture in the knee can involve the femur, kneecap, and tibial head.

Immediately after the accident there is acute knee pain and swelling of the knee due to bruises. The different locations of the fractures are associated with different symptoms and treatment options. If necessary, unshifted fractures can be treated with a plaster of paris and relief. In most cases, however, surgical correction and the insertion of plates and screws are required to stabilize the bone fragments.

Kneecap dislocation

Kneecap dislocations (sprains, dislocations) can occur frequently and recur. Often a one-off accident with twisting the leg is behind the dislocation. After that, the ligament structures can be changed in such a way that even slight external influences lead to dislocations. A kneecap dislocation can be acutely painful and often results in temporary joint effusion, which in turn causes swelling and pain.

The kneecap can be repositioned after the dislocation. In the long term, however, the quadriceps muscles should be strengthened to avoid further dislocations.

Read more on the topic:

• Kneecap dislocation
• Knees twisted
• Pain in the kneecap

Runner's knees

The runner's knee describes painful tendon irritation on the outer knee, which occurs especially in runners, cyclists and athletes with very frequent flexion and extension of the knee. Behind this is the tendon of the so-called "iliotibial ligament", which runs close to the protrusion of the thigh bone directly above the outer knee.

The frequent flexions can lead to painful irritations on this protruding bone, which can only be prevented by permanent rest. In the long term, certain loosening exercises, running shoes and other measures must be used to adapt the movement sequences in order to prevent the iliotibial ligament syndrome.

Read more on the topic: Runner's knees