What kind of doctor treats knee joints

The knee joint area is put under a lot of strain, especially if you are overweight or active. That is why pulling pain in the back of the knee is not uncommon, and the causes can be different, since in addition to the joint tissue, there are also lymph nodes, large blood vessels and nerves in this area. Some of these causes are quite harmless, others can be disabling and some can even be life-threatening. Therefore, this symptom should not be ignored. Let's look at what causes pain in this area, what to do and how to treat pain under the knee.

What is the knee and why does it hurt?

The knee is the largest joint in our body. In addition to the joint itself, it includes the ends of the femur and tibia, muscles, blood vessels, ligaments, nerves, meniscus, kneecap and joint capsule. Any of these substances can be damaged, but pain does not always occur because the nerve endings are not present everywhere.

Some injuries, such as B. a dislocated or torn meniscus restricts mobility. When small blood vessels are damaged, bruising and inflammation appear on the skin. Sometimes viral and bacterial infections develop in the joint capsule, which also cause pain. If the problem is in the nerves, severe pain will occur even if the joint is healthy.

What injuries cause knee pain?

The most common cause of acute knee pain is not post-traumatic arthritis or rheumatoid arthritis, but trauma. They occur due to an unfortunate fall, a sudden movement, strenuous exercise, or even walking in uncomfortable shoes.

The most common injuries that cause pain are.

• bruise – The knee is swollen, red and has localized fever; topical remedies and knee massage can relieve the pain;
• torn ligaments – occurs when the shinbone or femur is twisted to an unnatural side;
• meniscus tear – is caused by a blow to the leg that twists the lower extremity, preventing normal movement of the leg;
• Fractures of the knee joint, femur or tibia – Fractures of the knee joint, femur or tibia cause unbearable pain and excessive mobility and deformation of the knee.

If a fracture or dislocation is suspected, the patient is referred for an X-ray examination. If the doctor believes that a ligament, joint or meniscus is damaged, another examination is carried out - a CT or MRI.

If there is suspicion of joint, ligament or meniscus damage, an MRI examination is the appropriate procedure.

symptoms

If there is inflammation, the patient may have other clinical symptoms in addition to pain in the knee joint. This includes:

• Increased joint volume;
• Increased local temperature;
• redness;
• swelling;
• Restriction of movement.

Sometimes the pain in the knee joint accompanies the patient for the rest of his life. The patient feels discomfort in the legs during changes in the weather, colds and physical exertion. This is usually an indication of vascular disease. The nature of the sensations is symmetrical.

Sometimes the pain is transferred from one joint to another. This is one of the characteristic symptoms of rheumatoid arthritis. Even if the pain can be controlled, the joint will still be painful. At the same time, the patient also complains of joint stiffness.

Causes of persistent pain

The discomfort when bending the leg can be caused by damage to various components. This includes:

Prolonged knee pain can be a symptom of more than a hundred different diseases. Most often they are an indication of:

• Inflammatory diseases such as B. Osteoarthritis;
• hereditary diseases;
• weight gain;
• overloading the knee;
• Impaired blood supply;
• Systemic diseases such as arthritis;
• malignant tumors.

diagnosis

If a person suffers from severe knee pain, only an experienced doctor can diagnose the cause and prescribe treatment. To clarify the clinical picture, he prescribes the patient a series of diagnostic tests. This includes:

Basic methods for diagnosing knee pain

diagnostic methods	Time
arthroscopy	60 minutes
Magnetic resonance imaging of the knee joint	20 minutes
X-ray examination of the knee joint	10 mins

Magnetic resonance imaging

Magnetic resonance is based on the physical principle of the resonance of the atomic nuclei of organic compounds in a magnetic field. This type of examination makes it possible to make even the smallest tissue changes visible.

For example, diagnosing knee arthrosis (a degenerative-dystrophic disease accompanied by cartilage destruction) using MRI makes it possible to detect the pathological process even before irreversible cartilage changes develop.

The main disadvantage of this imaging method is that it cannot be performed when there are metal implants in the patient's body.

Magnetic resonance imaging

Magnetic resonance imaging

Ultrasound examination of the knee joints can detect tissue conditions that are not visible with X-ray procedures. These include the connective tissue capsule and the ligamentous apparatus. In particular, a ligament tear in the knee joint can be diagnosed qualitatively with this examination.

This technique can also be used to determine the amount of synovial fluid in the joint cavity, which can increase in various inflammatory diseases.

Under ultrasound control, medications (hyaluronic acid, anti-inflammatory agents) can also be injected into the joint cavity using a special needle. Diagnosis of knee osteoarthritis allows medication to be administered under ultrasound control.

Knee pain when walking

Knee pain when walking is a common complaint among people of all ages. The knee joint is exposed to a lot of stress, so problems can occur from time to time. This symptom also occurs in pathological conditions accompanied by damage to the joint and surrounding anatomical structures. Since the patient is unable to determine the cause of the symptoms himself, an examination is necessary. Only a specialist can make a final diagnosis and prescribe timely treatment.

Specialist talks about CMRT

Published Date: September 25, 2021 Follow-up Date: February 2, 2023 All facts have been verified by a doctor.

Causes of knee pain when walking

• Arthrosis. In knee osteoarthritis, the cartilage is destroyed, which leads to damage to other components of the joint.
• Inflammatory processes affecting the joint. With osteoarthritis, the knee regularly hurts when flexed and extended.
• Interruption of blood supply to tissues. This can cause severe pain in the right or left knee joint when walking due to the degeneration of the cartilage and the intense friction between the bone surfaces.
• Damage to the meniscus. The cushioning and stabilizing function of the joint is impaired.
• Entrapment of nerves. This can cause the knee to 'pulsate'.
• Tendonitis. The symptom quickly worsens with movement.
• Discomfort in this anatomical area is more often associated with degeneration and wear of the joint components.

Severe knee pain when walking is classified depending on the severity and duration of the symptoms. Depending on the type of disease, the patient may experience a pulling, shooting, throbbing or stabbing sensation in the knee area. Clarifying the nature of the symptom will help the specialist make a diagnosis.

Severe knee pain when walking

Characterized by an acute onset and more severe pain syndrome. It can last from a few hours to several days or even weeks. Severe pain often prevents patients from walking and performing normal activities. The knee is swollen and red. There is significant swelling.

Chronic pain in the knee joint

This symptom can last for months or years and does not go away on its own. The pain occasionally becomes less severe and increases with walking. Mild nagging pain may be replaced by a brief stabbing (shooting) pain upon sudden movement. The rest of the time the patient feels a feeling of heaviness in the knee.

Prevention of knee pain

Risk factors include obesity, lack of physical activity or excessive stress on the knee joints, frequent injuries and a hereditary predisposition to joint diseases. Maintaining the health of the knee joints can be supported by a healthy lifestyle. This includes:

• maintaining a healthy body weight;
• an optimal level of exercise, including strength and endurance training;
• a balanced diet;
• adequate sleep;
• hardening;
• avoiding injuries and overexertion;
• increasing stress tolerance;
• regular monitoring of blood composition and measures to correct any identified deficiency of vital vitamins and minerals.

To avoid disability and dangerous, life-threatening complications, you should see your doctor at the first sign of discomfort or pain in the hamstring area.

classification

Arthralgia differs in location and depth, number of affected joints, type and severity of pain syndrome, daily rhythm, duration and interaction with a particular type of movement. If the pain occurs in one joint, it is called monoartralgia; If the pain occurs in several joints at the same time or one after the other, it is called oligoartralgia; If five or more joints are affected, it is called polyartralgia.

The type of arthralgia syndrome is divided into acute and dull pain, the intensity into mild to moderate to intense, and the course into temporary and persistent. Joint pain occurs more often in large joints such as hips, knees, shoulders and elbows, and less often in medium and small joints such as wrists, ankles and interphalangeal joints.

Joint pain is caused by irritation of the neuroreceptors of the synovial membrane of the joint capsules by inflammatory mediators, products of immune reactions, salt crystals, toxins and osteophytes. Rheumatology defines the following types of joint pain:

• caused by toxic syndrome in acute infections;
• primary or intermittent arthralgia in acute or recurrent arthritis;
• long-term monoarthralgia of large joints;
• oligo- or polyarthralgic syndrome with involvement of the synovial membrane or progressive degenerative-dystrophic cartilage changes;
• residual post-inflammatory or post-traumatic joint pain;
• Pseudoarthralgia.

Why does joint pain occur?

General infectious diseases

Joint pain often accompanies the course of acute infections. Joint pain can occur both in the prodromal period of the disease and in the early clinical phase with fever and intoxication. The infectious form of arthralgia is characterized by pain in the joints of the upper and lower limbs, pain in multiple joints and coupling with myalgia. The mobility of the joints is completely preserved. Infectious arthralgia usually disappears within a few days with the disappearance of the toxic syndrome of the underlying disease.

Infectious arthralgia

Reactive postinfectious arthralgia may occur after acute intestinal or genitourinary infections or in parainfectious arthralgia secondary to tuberculosis, infective endocarditis, or secondary syphilis. Arthralgia is often caused by a pre-existing chronic infection such as pyelonephritis, cholangitis, appendicitis, periarticular abscess, or parasitic infection.

Residual arthritis is chronic or temporary in nature. Joint pain and stiffness can last for weeks or months; Afterwards, the well-being and function of the limbs are completely restored. In the chronic form of arthralgia, exacerbations may be associated with overexertion, weather instability, or hypothermia.

Rheumatic diseases

Joint pain in the form of polyarthralgia or ologarthralgia is the main symptom of inflammatory rheumatic diseases. Rheumatic arthralgias are characterized by a persistent, intense, migratory pain syndrome, involvement of large joints, especially the lower limbs, and limitation of joint mobility.

As with systemic rheumatic diseases, the onset of rheumatoid arthritis is characterized by a multijoint syndrome involving the small symmetrical joints of the feet and hands and morning stiffness.

What are joints?

The human body has more than 200 joints that enable it to move. They are located at the junctions of the bones where important movements take place: extension, flexion, adduction, rotation, etc. The joints reduce the friction of the bones against each other and prevent them from being destroyed by mechanical action.

1. Articular surface – covered with cartilage that absorbs shock.
2. Joint capsule – the structure attached to the articular surface and protecting its contents from mechanical injuries and tears. The fibers of ligaments and tendons are woven into it, so the capsule reacts violently to any destructive, inflammatory process, which manifests itself as pain.
3. Synovial fluid – located inside the capsule. It nourishes and lubricates the joint and prevents it from being worn down by friction. When the fluid becomes inflamed, pain occurs.
4. The joint cavity is the hermetically sealed gap between the capsule and the surface. It can contain articular cartilage (meniscus, intervertebral discs), which acts as a shock absorber.

In addition to the joints, ligaments and tendons are also involved in the movement of bones. Ligaments connect bones to internal organs or other parts of the skeleton. They contain many nerve fibers, which is why a sprain is always accompanied by pain. Tendons are collagenous thread structures that connect striated muscles to the skeleton.

Diagnosis of joint diseases: types

In order to prescribe the correct treatment for spine and joint diseases, the cause of the pain must be determined. This cannot be accurately determined by visual inspection; a diagnosis is required. Two methods are used:

• Instrumental diagnosis – examination using various devices (MRI or X-ray of the knee joint, ultrasound, etc.), which allows a detailed study of the condition of the affected organ;
• Laboratory diagnosis – general and biochemical blood tests, urine tests and synovial fluid tests.

The two methods complement each other and therefore cannot be separated. The doctor can only get a clear picture with blood tests, X-rays, CT or MRI scans. Sometimes instrumental diagnosis may be limited to whether the dislocation is visible on the x-ray. If this occurs, the limb is immobilized and anesthetics are administered. Further examinations are usually not necessary.

Diagnosis of knee pain

The specialists at CELT's multidisciplinary knee clinic recommend that you seek immediate medical attention if you experience any of the following symptoms

• Visible deformation of the knee joint;
• Persistent pain in the knee;
• inability to step on the leg;
• Local redness of the skin;
• swelling or swelling of the joint;
• Increase in general body temperature.

In order to properly treat your knee pain, our specialists will carry out a diagnostic examination, which, in addition to a medical history and a visual examination, may also include the following:

• an ultrasound scan of the joint;
• ROENTGEN;
• arthroscopy;
• blood tests;
• Urinalysis (if gout is suspected);
• magnetic resonance imaging;
• Atrography of the knee joint.

Treatment of knee pain

Treatment of knee joint pain is recommended by CELT specialists on an individual basis, taking into account the diagnosis and individual characteristics of the patient.

Osteoarthritis is treated with medication and physical therapy. It is also possible to suppress the pain impulses in the knee joint using radiofrequency current denervation. This technique is actively used in the CELT clinic for pain therapy. In extreme cases, surgery is performed to replace the joint with an endoprosthesis.

Treatment for diseases such as rheumatoid arthritis and osteoarthritis aims to minimize pain and inflammation.

Particular attention is paid to maintaining the functionality of the knee joint. For this purpose, medications, anti-inflammatory drugs and painkillers are used. Surgery is also possible, but is only performed if the joint is severely deformed.

A torn meniscus requires surgery to stitch the damaged cartilage back together. The dislocated meniscus is set back into place by a trauma surgeon and then placed in a plaster cast.

Pain in the knee joint caused by a vascular disease is treated with massage, vasodilators and special ointments.

Newly occurring Becker cysts are treated with conservative methods to relieve the inflammation. At the same time, the underlying disease that led to its development is treated. In the most advanced cases, surgery is required to completely remove the affected membrane.

Knee pain treatment will definitely be successful and restore your life to what it was before if you come to CELT clinic! Our strengths are a team of experienced doctors, a wide range of the most effective treatment methods and the most modern equipment for accurate diagnosis and treatment of a wide range of pathologies.

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