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Knee Injury Acute History

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Knee Injury Acute History, Knee Injury

  • See Also
  1. Knee Exam
  2. Knee Pain
  • History
  • Mechanism of injury
  1. Type of activity
  2. Type of Trauma (Contact?)
  3. Playing surface (Concrete?)
  • History
  • Red Flags
  1. Possible Fracture, dislocation, or tendon or ligament rupture
    1. Severe acute pain
    2. Immediate swelling with injury
    3. Instability
    4. Inability to bear weight
  2. Septic Joint
    1. Fever
    2. Erythema
    3. Limited range of motion
  • History
  • Direction of injury force
  1. Hyperextension Injury
    1. Anterior Cruciate Ligament Tear
    2. Patella Dislocation
  2. Direct blow to lateral side of knee (Valgus Stress)
    1. Medial Collateral Ligament Injury
    2. Knee Dislocation (Tibial Femoral Dislocation) or Knee Subluxation
    3. Tibial Plateau Fracture
  3. Direct blow to medial side of knee (Varus Stress)
    1. Lateral Collateral Ligament Injury
    2. Knee Dislocation (Tibial Femoral Dislocation) or Knee Subluxation
    3. Tibial Plateau Fracture
  4. Direct blow to anterior knee (e.g. knee hits dashboard)
    1. Posterior Cruciate Ligament injury
    2. Knee Dislocation (Tibial Femoral Dislocation) or Knee Subluxation
    3. Patella Fracture
  5. Twisting Injury
    1. Anterior Cruciate Ligament Tear
    2. Meniscus Injury
    3. Patella subluxation or Patella dislocation
  6. Quick stop or sharp cut
    1. Anterior Cruciate Ligament Tear
  1. "Snap" or "pop" at time of injury
    1. Anterior Cruciate Ligament Tear
  2. Locking, clicking or catching Sensation
    1. Meniscus Injury
    2. Knee Joint loose bodies
  3. Knee locks in flexed position
    1. Bucket-handle tear (anterior to MCL)
  4. Giving-way or buckling Sensation
    1. Anterior Cruciate Ligament Tear
    2. Meniscus Injury
    3. Patella subluxation
    4. Knee Joint loose bodies
  • History
  • Immediate Knee Swelling and difficult walking (or unable to ambulate)?
  1. Anterior Cruciate Ligament Tear
  2. Acute Patella dislocation
  3. Osteochondral Fracture (Tibial Plateau Fracture)
  4. Knee Dislocation (Tibial Femoral Dislocation) or Knee Subluxation
  5. Tibial Plateau Fracture
  6. Patella Fracture
  7. Proximal Fibula Fracture
  • History
  • Athlete continued participating in activity after Injury
  1. Meniscus Injury
  2. Patella subluxation
  3. Mild collateral ligament injury
  • History
  • Morning stiffness lasts >30 minutes (esp. Polyarticular)
  1. See Knee Pain for age-related Knee Pain causes
  2. Age <50 years
    1. Rheumatoid Arthritis
    2. Reactive Arthropathy
    3. Systemic Lupus Erythematosus
  3. Age >50 years
    1. Knee Osteoarthritis
  • History
  • Other Relevant History
  1. See Acute Knee Pain
  2. Knee Pain history
    1. Knee Pain duration
    2. Knee Pain location ("point with one finger")
      1. See Knee Pain for location-related Knee Pain causes
  3. Knee Injury history
    1. History of prior Knee Injury
    2. History of change in recent activities
  4. Other red flags
    1. Acute Monoarthritis
      1. Differentiate from acute knee hemarthrosis
      2. Exclude acute Septic Arthritis
      3. Consider exacerbation of knee inflammatory conditions (e.g. gout, RA, Pseudogout)
      4. Consider Open Joint Injury
    2. Malignancy
      1. Unintentional Weight Loss
      2. Fever
      3. Night Sweats
      4. Night pain
  5. Past medical history
    1. Prior knee injuries or surgeries
    2. Sexually Transmitted Infections (e.g. Gonorrhea, Chlamydia, Syphilis)
    3. Lyme Disease
    4. Concurrent rheumatic or Autoimmune Conditions
      1. Acute Gouty Arthritis
      2. Pseudogout
      3. Rheumatoid Arthritis
      4. Knee Osteoarthritis
  • References
  1. Bunt (2018) Am Fam Physician 98(9): 576-85 [PubMed]
  2. Pendergraph (2026) Am Fam Physician 114(1): 49-62 [PubMed]