Knee space snapping and pain

Introduction Significant bounce and pain in the knee joint is a manifestation of clinical diagnosis of meniscus injury. Meniscus injury is one of the most common injuries in the knee, more common in young adults, more men than women.

Cause

(1) Causes of the disease

Rotating external force.

(two) pathogenesis

Meniscus injury is most likely to occur when the knee joint is flexed to straight and accompanied by rotation. The meniscus injury is mostly in the medial meniscus. The most common one is the injury of the posterior horn of the meniscus, and the longitudinal fracture is the most. The length, depth and location of the tear depends on the relationship between the femur and the humerus at the posterior horn of the meniscus. Congenital anomalies in the meniscus, especially the lateral discoid cartilage, are more likely to cause degeneration or damage. Congenital joint relaxation and other internal disorders can also increase the risk of meniscus injury.

an examination

Related inspection

Synovial fluid visual inspection

1. Common signs of tenderness are localized tenderness around the medial and lateral space of the knee joint or around the meniscus.

2. McMurray test patient supine position, the examiner with one hand against the inner edge of the joint, control the medial meniscus, the other hand grips the foot, the knee joint is fully flexed, the calf is externally rotated, and then the knee joint is slowly extended. Or feel the bounce or bounce; then touch the outer edge of the joint with your hand, control the lateral meniscus, the inner leg of the calf valgus, slowly stretch the knee joint, hear or feel the sound or bounce, that is, the test is positive.

The sound generated by the McMurray test or the sudden pain of the patient during the examination often has a certain significance for the positioning of the meniscus tear: the knee joint is fully flexed to 90°, and the posterior margin of the meniscus is often prompted; When the knee joint is struck in a large straight position, it prompts the middle or front of the meniscus to tear.

3. Apley grinding test patient prone position, knee flexion 90 °, the front of the thigh is fixed on the examination table, the foot and the lower leg are lifted up, the joint is separated and rotated, and the tension is tightened on the ligament, if the ligament is torn, There was significant pain during the test. Thereafter, the knee joint is in the same position, the foot and the lower leg are pressed down and the joint is rotated, and the joint is slowly flexed and stretched. When the meniscus is torn, the knee joint space can have obvious bounce and pain.

4. Classification of meniscus injuries Classification of meniscus tears has guiding significance for diagnosis and selection of reasonable surgical treatment methods. There are many different classification methods for meniscal tears. It is more common to divide them into marginal, central, longitudinal ruptures (ie, "barrel-type" ruptures), anterior or posterior valvular ruptures, and rare half-months. The horizontal shape of the middle of the plate is broken.

History of trauma, localized localized pain, joint swelling, squeaking and interlocking, and atrophy of the medial head of the quadriceps. Local tenderness, McMurray test (+), Apley grinding test (+). X-ray examination excludes other bone diseases, MRI examination, can confirm the diagnosis.

Differential diagnosis

Knee pain: The main symptoms of the old cold legs, mostly knee pain. Recurrent, long-lasting legs (mostly knee joints) sore pain, collectively known as the old cold legs. The medial swelling of the knee joint is bruising and local pain. In most cases, the knee joint suffers from sudden valgus or external rotation. After the ligament is broken, the inside of the knee joint is generally swollen, local pain, subcutaneous congestion, and bruising.

1. Common signs of tenderness are localized tenderness around the medial and lateral space of the knee joint or around the meniscus.

2. McMurray test patient supine position, the examiner with one hand against the inner edge of the joint, control the medial meniscus, the other hand grips the foot, the knee joint is fully flexed, the calf is externally rotated, and then the knee joint is slowly extended. Or feel the bounce or bounce; then touch the outer edge of the joint with your hand, control the lateral meniscus, the inner leg of the calf valgus, slowly stretch the knee joint, hear or feel the sound or bounce, that is, the test is positive.

The sound generated by the McMurray test or the sudden pain of the patient during the examination often has a certain significance for the positioning of the meniscus tear: the knee joint is fully flexed to 90°, and the posterior margin of the meniscus is often prompted; When the knee joint is struck in a large straight position, it prompts the middle or front of the meniscus to tear.

3. Apley grinding test patient prone position, knee flexion 90 °, the front of the thigh is fixed on the examination table, the foot and the lower leg are lifted up, the joint is separated and rotated, and the tension is tightened on the ligament, if the ligament is torn, There was significant pain during the test. Thereafter, the knee joint is in the same position, the foot and the lower leg are pressed down and the joint is rotated, and the joint is slowly flexed and stretched. When the meniscus is torn, the knee joint space can have obvious bounce and pain.

4. Classification of meniscus injuries Classification of meniscus tears has guiding significance for diagnosis and selection of reasonable surgical treatment methods.

There are many different classification methods for meniscal tears. It is more common to divide them into marginal, central, longitudinal ruptures (ie, "barrel-type" ruptures), anterior or posterior valvular ruptures, and rare half-months. The horizontal shape of the middle of the plate is broken.

History of trauma, localized localized pain, joint swelling, squeaking and interlocking, and atrophy of the medial head of the quadriceps. Local tenderness, McMurray test (+), Apley grinding test (+). X-ray examination excludes other bone diseases, MRI examination, can confirm the diagnosis.

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