Knee Pain: Causes and Treatment Options for Swelling

Pain in the popliteal region?

Hello, doctor.
I would like to ask about my right knee, which appears to be somewhat swollen, and I have been experiencing unexplained pain in the popliteal area for several years.
I am unable to squat fully; bending to about 90 degrees causes significant discomfort.
What could be the underlying condition? How should I seek medical attention? I previously consulted an orthopedic specialist and underwent an ultrasound, but the doctor informed me that the bones appeared normal.
I have taken various anti-inflammatory medications and received muscle relaxants, but there has been little improvement.
What should I do? Thank you.

Chen Nan, 30~39 year old female. Ask Date: 2019/05/24

Dr. Shi Guozheng reply Orthopedics

Is there a possibility of a cyst in the popliteal area if there is swelling in the knee joint? The bones are fine, so it could be a soft tissue issue such as a ligament or meniscus injury.
Additionally, could it be related to gout (high uric acid levels)? It may be necessary to consult another physician for a detailed evaluation or to undergo further testing.

Reply Date: 2019/05/24

More Info

Knee pain and swelling can be quite debilitating and frustrating, especially when the cause is not immediately clear. Based on your description, it seems that you have been experiencing persistent swelling and pain in your right knee, particularly in the popliteal area (the back of the knee), which has limited your ability to bend your knee beyond 90 degrees. This situation can be indicative of several underlying issues, and it is essential to explore potential causes and treatment options.

Possible Causes of Knee Pain and Swelling
1. Patellofemoral Pain Syndrome (PFPS): This condition is characterized by pain around the kneecap (patella) and can be exacerbated by activities that put stress on the knee joint, such as squatting or climbing stairs. It often occurs due to muscle imbalances, overuse, or misalignment of the knee.

2. Meniscus Tear: A tear in the meniscus, the cartilage that cushions the knee joint, can cause swelling and pain, particularly when bending or twisting the knee. This is often accompanied by a sensation of locking or catching in the knee.

3. Osteoarthritis: This degenerative joint disease can lead to the breakdown of cartilage, resulting in pain, swelling, and stiffness. It is common in older adults but can also occur in younger individuals, especially if there is a history of knee injuries.

4. Bursitis: Inflammation of the bursae (small fluid-filled sacs that cushion the knee joint) can lead to swelling and pain. This is often due to repetitive movements or prolonged pressure on the knee.

5. Tendinitis: Inflammation of the tendons around the knee, such as patellar tendinitis, can cause pain and swelling, particularly with activities that involve jumping or running.

6. Synovitis: Inflammation of the synovial membrane, which lines the joint, can lead to swelling and pain. This condition can be associated with various forms of arthritis or injury.

Recommended Steps for Diagnosis and Treatment
1. Consult a Specialist: Since you have already seen an orthopedic doctor and undergone ultrasound imaging, it may be beneficial to seek a second opinion or consult a rheumatologist, especially if inflammatory conditions are suspected.

2. Imaging Studies: If not already done, consider advanced imaging studies such as MRI, which can provide a more detailed view of soft tissues, including cartilage, ligaments, and menisci.

3. Physical Therapy: Engaging in a structured physical therapy program can help strengthen the muscles around the knee, improve flexibility, and address any biomechanical issues contributing to your pain. A physical therapist can design a personalized exercise regimen tailored to your specific needs.

4. Activity Modification: Avoid activities that exacerbate your knee pain, such as deep squatting or high-impact exercises. Instead, focus on low-impact activities like swimming or cycling that are less stressful on the joints.

5. Pain Management: Continue to use anti-inflammatory medications as prescribed by your doctor. Additionally, consider using ice packs to reduce swelling and pain after activities that aggravate your knee.

6. Injections: If conservative treatments fail, corticosteroid injections may provide temporary relief from inflammation and pain. Hyaluronic acid injections are another option that may help lubricate the joint.

7. Surgical Options: If all conservative measures fail and your quality of life is significantly affected, surgical options such as arthroscopy to repair a meniscus tear or debridement of damaged cartilage may be considered.

Conclusion
Knee pain and swelling can stem from various causes, and it is crucial to identify the underlying issue to determine the most effective treatment. Given your history and the persistent nature of your symptoms, further evaluation and a tailored treatment plan are essential. Collaborating with healthcare professionals, including orthopedic specialists and physical therapists, can help you manage your symptoms and improve your knee function. Remember to communicate openly with your healthcare providers about your symptoms and any changes you experience, as this will aid in developing an effective management strategy.

Similar Q&A

Understanding Knee Pain and Swelling: Causes and Solutions for Seniors

This afternoon, while shopping, I suddenly experienced some pain in my left knee, making it difficult to walk. When I got home, I noticed that my knee was swollen. It hurts when I press on the sides of the knee, but the top and bottom are fine. The swelling did not go down at all...

Dr. Liang Yinpan reply Geriatrics
Hello Chiaochen: The causes of knee swelling and pain include: 1. Strain from improper use, 2. Degeneration from prolonged weight-bearing, 3. Infection and inflammation. It is advisable to seek orthopedic treatment promptly. Wishing you a speedy recovery. Liang Yin-Pan, Departmen...

Understanding Recurring Knee Swelling: Causes and Solutions

Hello Doctor: I previously fell and injured my left foot, but I'm not sure if this is the reason for the persistent swelling and inflammation in my knee. The first time it swelled, it was so severe that I couldn't walk or bend it at all. I went to Cathay General Hospita...

Dr. Xiao Yongxun reply Internal Medicine
1. Knee pain is a common site for sports injuries, degenerative arthritis, inflammatory arthritis, and infectious arthritis. From a clinical anatomical perspective, the joint structures to consider are the medial tibiofemoral, lateral tibiofemoral, and patellofemoral compartments...

Understanding Knee Hematomas: Causes, Symptoms, and Treatment Options

Hello Doctor, my knee has been experiencing abnormal pain since I seemingly strained it one day. After seeing a doctor, I was told it was inflammation with effusion. I was advised to rest, which should help, but even after three months, there is still a small swollen area at the ...

Dr. Shi Guozheng reply Orthopedics
If the swelling is located directly in front of the kneecap, the most likely diagnosis is prepatellar bursitis. If it causes pain, treatment with medication is necessary. The physician may need to aspirate the fluid; if it persists after several aspirations, surgical intervention...

Understanding Post-Knee Surgery Swelling: Causes and Treatments

Swelling of the feet and ankles that occurs in the morning but worsens by the afternoon may be due to several reasons, including fluid retention, prolonged standing or sitting, or underlying conditions such as heart, kidney, or liver issues. Treatment options may include elevatin...

Dr. Shi Guozheng reply Orthopedics
It may be that the knee surgery has affected the blood circulation in the lower limb. Elevating the affected leg for a period of time can help reduce swelling, and repeating this several times will gradually decrease the swelling. Typically, the swelling can last for one to two m...