Swollen Knee After Car Accident: When to Seek Further Medical Evaluation

Knee swelling due to injuries from a car accident?

Hello, Doctor.
I would like to ask about an incident that occurred on November 3rd when I was involved in a car accident that impacted the outer side of my right knee.
However, I am experiencing significant pain and swelling on the inner side of my right knee, especially when bending or kneeling, which feels like a tearing sensation.
By mid-November, I still felt pain (although it has improved compared to the pain at the time of the accident).
I have started physical therapy in the rehabilitation department (including electrical stimulation and far-infrared therapy), but in the past few days, the swelling and pain have become more pronounced (even tight pants cause discomfort), and the swelling seems worse than it was at the time of the accident.
Walking is not an issue, but I would like to know if I should continue with rehabilitation or seek further evaluation.

Lai Xiaojie, 20~29 year old female. Ask Date: 2018/12/09

Dr. Chen Yongxue reply Orthopedics

Hello.
Ms.
Lai mentioned the issue of swelling and pain in her right knee.
It may be necessary to inform me of the final diagnosis, as the same symptoms can lead to completely different treatment approaches depending on the diagnosis.
If there are any doubts about the diagnosis, please visit the orthopedic outpatient clinic for further examination.
Thank you.

Reply Date: 2018/12/09

More Info

After a car accident, experiencing swelling and pain in the knee can be concerning, especially if the symptoms seem to worsen over time. Based on your description, it sounds like you sustained an injury to your right knee, particularly on the outer side, and are now experiencing significant pain and swelling, especially when bending or kneeling. While some improvement has been noted since the accident, the recent increase in swelling and pain is a red flag that warrants further evaluation.

In general, after a traumatic injury like a car accident, it's crucial to monitor your symptoms closely. Initial imaging, such as X-rays, may not always reveal soft tissue injuries, which can include damage to ligaments, cartilage, or muscles. These types of injuries may not be visible on X-rays, and symptoms can evolve over time. Given that you are experiencing increased swelling and pain, it is advisable to seek further medical evaluation.

Here are some key points to consider regarding your situation:
1. Persistent Symptoms: If you notice that your symptoms are not improving or are worsening despite ongoing physical therapy, this is a strong indication that further investigation is needed. Conditions such as ligament tears (e.g., ACL or MCL injuries), meniscus tears, or even bursitis could be contributing to your symptoms.

2. Physical Examination: A thorough examination by an orthopedic specialist can provide insights into the nature of your injury. They may perform specific tests to assess the stability of the knee and check for any signs of ligament damage or other structural issues.

3. Imaging Studies: If the physical examination raises concerns, your doctor may recommend additional imaging studies, such as an MRI. An MRI is particularly useful for visualizing soft tissue injuries, including tears in ligaments or cartilage, which are common after knee trauma.

4. Treatment Options: Depending on the findings from your evaluation, treatment options may vary. If a significant injury is identified, you may require more intensive rehabilitation, or in some cases, surgical intervention may be necessary to repair damaged structures.

5. Self-Care Measures: In the meantime, continue to manage your symptoms with rest, ice, compression, and elevation (RICE). Avoid activities that exacerbate your pain, and consider using a knee brace for additional support during your daily activities.

6. Follow-Up: Regular follow-up with your healthcare provider is essential to monitor your recovery progress. If your symptoms do not improve or worsen, do not hesitate to return for further evaluation.

In conclusion, while physical therapy can be beneficial, the worsening of your symptoms suggests that further medical evaluation is warranted. It is better to err on the side of caution, especially with knee injuries, as early intervention can lead to better outcomes and prevent long-term complications. Please consult with an orthopedic specialist to ensure you receive the appropriate care for your knee injury.

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