Knee Pain and Problems

Brief anatomy of the knee:

The knee is a vulnerable joint that bears a great deal of stress from everyday activities such as lifting and kneeling, and from high-impact activities such as jogging and aerobics.

The knee is formed by the following parts:

• tibia – shin bone or larger bone of the lower leg.
• femur – thighbone or upper leg bone.
• patella – kneecap.

Each bone end is covered with a layer of cartilage that absorbs shock and protects the knee. Basically, the knee is two long leg bones held together by muscles, ligaments, and tendons.

There are two groups of muscles involved in the knee, including the quadriceps muscles (located on the front of the thighs), which straighten the legs, and the hamstring muscles (located on the back of the thighs), which bend the leg at the knee.

Tendons are tough cords of tissue that connect muscles to bones. Ligaments are elastic bands of tissue that connect bone to bone. Some ligaments on the knee provide stability and protection of the joints, while other ligaments limit forward and backward movement of the tibia (shin bone).

How are knee problems diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for knee problems may include the following:

• x-ray – a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
• magnetic resonance imaging (MRI) – a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body; can often determine damage or disease in a surrounding ligament or muscle.
• computed tomography scan (Also called a CT or CAT scan.) – a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.
• arthroscopy – a minimally-invasive diagnostic and treatment procedure used for conditions of a joint. This procedure uses a small, lighted, optic tube (arthroscope) which is inserted into the joint through a small incision in the joint. Images of the inside of the joint are projected onto a screen; used to evaluate any degenerative and/or arthritic changes in the joint; to detect bone diseases and tumors; to determine the cause of bone pain and inflammation.
• radionuclide bone scan – a nuclear imaging technique that uses a very small amount of radioactive material, which is injected into the patient’s bloodstream to be detected by a scanner. This test shows blood flow to the bone and cell activity within the bone.

Treatment for knee problems:

Specific treatment for knee problems will be determined by your physician based on:

• your age, overall health, and medical history
• extent of the disease, injury, or condition
• your tolerance for specific medications, procedures, or therapies
• expectations for the course of the disease, injury, or condition
• your opinion or preference

If initial treatment methods do not provide relief, and x-rays show destruction of the joint, the orthopaedist may recommend total joint replacement for the knee.