Avoid misdiagnosis of knee pain health advisor

Avoid misdiagnosis of knee painIt presses, it grinds, it hurts or stings – complaints in the knee are as varied as their possible causes. The knee is a complicated joint, and this often makes the path to the correct diagnosis difficult. Misdiagnoses and unnecessary operations are stressful for those affected and are not uncommon, particularly in the case of knee complaints. It may take years to discover that an osteoarthritis patient is actually suffering from a malposition of the kneecap.

According to international studies, doctors are wrong in about 15 percent of all diagnoses. Exact figures for Germany are not available, but experts ame a comparable rate here.

Dozens of possible causes of knee pain

The most common complaints include problems with the kneecap, with the cruciate ligaments or meniscus injuries. Orthopedist. Sports physician Dr. Helge Riepenhof to consider. The most common complaints include problems with the kneecap, with the cruciate ligaments and meniscus injuries. However, there are quite a few other diseases that can be manifested by knee pain. These include, for example, rheumatoid arthritis, but also gout, psoriasis, Lyme disease spread by ticks, or infectious diseases.

Precise description of the pain provides the first clue

Essential clues to the cause of the complaints are usually already provided by the patient interview. It is therefore extremely important that the doctor takes enough time for the patient to describe his pain as precisely as possible. Four simple questions usually put the doctor on the right track:

Important question for knee pain

– Do the symptoms tend to occur in the morning when you get up or at the end of the day, after a long period of exertion?? – What is the nature of the pain (stabbing, pressing, dull, sharp, etc.)? . )? – How exactly did the complaints start or when/where did they first occur?? – What has happened since then? How has the pain developed?

After the consultation, the doctor will carefully examine the knee, check the mobility and stability of the joint, and scan it for possible swelling or effusion. He then examines the muscles and adjacent joints, such as the hip and ankle, in order to clarify the relationships between them.

If inflammatory processes are suspected, various blood tests are also carried out, for example for inflammation and rheumatism factors, and if gout is suspected, also for elevated uric acid levels. In rare cases, a puncture may be necessary to have the synovial fluid examined in the laboratory for signs of rheumatism or certain germs. The puncture itself involves a risk of infection that cannot be completely ruled out.

When X-rays, MRIs and ultrasound are useful

If treatment with physiotherapy and painkillers does not bring rapid relief, the doctor will use imaging techniques, especially X-rays if osteoarthritis is suspected. In younger people, magnetic resonance imaging (MRI) or ultrasound are more likely to be considered instead of X-rays, because they allow better assessment of possible damage to soft ties such as ligaments or menisci. Rarely, nuclear medical examinations (bone scintigraphy) will be necessary – they provide information about changes in bone metabolism, for example due to inflammation or tumors.

Surgery as a last resort

"Before surgery, however, if it is not an emergency, treatment with physical therapy and, if necessary, pain-relieving medications should always be attempted", emphasizes the orthopedist and rehabilitation physician Dr. Christian Sturm. Stabilizing exercises and self-awareness (proprioception) are particularly important – these measures can often alleviate the symptoms in the medium and long term: "As a patient, you can do a lot yourself at home, for example by doing daily exercises standing on one leg. With all the modern technical possibilities, the detailed discussion remains the most important thing. The precise examination by the doctor the most important part of the diagnostics. An X-ray alone is not a sufficient diagnosis – and the error rates in interpreting X-rays are not exactly low at ten percent, according to a large meta-analysis in the USA in 2008.

Patients should therefore trust their bodies and look for a doctor who takes the problem seriously and understands it. If you are unsure, you should consider the keyword "surgery" at the latest get a second opinion to avoid unnecessary surgery.

Exercise therapy for patellar malalignment

Muscles center the kneecap. If the balance between them is not right, this accelerates wear and tear – targeted training, on the other hand, stabilizes the kneecap in the sliding bearing. more

What helps with chronic knee pain?

In the case of chronic pain in the knee, a so-called multimodal therapy can help – with targeted exercise, physiotherapy and psychotherapy.

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