Knee Pain: Causes and Management of Patellar Bumps

Knee Pain Consultation

Hello Dr.
Ke,
Two years ago, I was involved in a car accident that resulted in a contusion and bruising of my right knee.
I subsequently visited an orthopedic clinic for an X-ray, and the doctor confirmed that there were no fractures, cracks, or dislocations in my right knee, only soft tissue injuries.
Earlier this year, I noticed a protruding round spot at the lower edge of the patella on my right knee, which causes significant sharp pain when pressed.
However, it does not affect my daily activities; as long as I avoid pressing on the protruding spot, I can live normally.

I would like to ask you, Dr.
Ke:
1.
Based on your experience and opinion, what could be the possible issues or conditions related to the protruding round spot at the lower edge of my right knee patella that causes sharp pain upon pressure? (e.g., bursitis, etc.)
2.
In your opinion, what would be the best course of action at this point? (e.g., seeking medical treatment or self-managing with heat application, topical ointments, and monitoring for spontaneous recovery)
Thank you, Dr.
Ke.

Axiang, 30~39 year old female. Ask Date: 2019/12/06

Dr. Ke Fangxu reply Surgery

1.
Is the inferior border of the patella located above the patella or on the ligament? Is it connected to the tibia? Has the stability of the knee joint deteriorated? These are all factors in assessing pain points and soft tissue injuries.
It is recommended that you consult an orthopedic physician for evaluation.
If necessary, soft tissue ultrasound or MRI scans may be required for a definitive diagnosis.

2.
You can start with heat therapy or use topical ointments and adhesive patches.
Knee braces may also be beneficial.
If symptoms do not improve, it is advisable to seek a professional medical diagnosis.

Reply Date: 2019/12/06

More Info

Knee pain, particularly in the context of a previous injury, can be a complex issue that often involves various structures around the knee joint, including bones, cartilage, ligaments, and tendons. Given your history of a car accident that resulted in a bruise and contusion to your right knee, it is understandable that you are experiencing ongoing discomfort, particularly with the newly developed bump on the lower edge of your patella (kneecap).

1. Possible Causes of the Bump and Pain: The prominent round point you describe at the lower edge of your patella could be indicative of several conditions. One possibility is prepatellar bursitis, which is inflammation of the bursa located in front of the kneecap. This condition can occur due to trauma, repetitive stress, or prolonged kneeling. The pain you experience upon pressing the bump aligns with this diagnosis. Another potential cause could be patellar tendinopathy, which involves degeneration of the tendon that connects the kneecap to the shinbone, often due to overuse or injury. Additionally, it could also be a bone spur or a calcified tendon, which can develop as a result of chronic irritation or injury.

2. Management and Treatment Options: Given that the bump does not significantly affect your daily activities unless pressed, conservative management may be appropriate. Here are some recommendations:
- Rest and Activity Modification: Avoid activities that exacerbate your pain, particularly those that involve kneeling or putting pressure on the knee. If you engage in sports or physical activities, consider modifying your routine to reduce strain on the knee.

- Ice Therapy: Applying ice to the affected area can help reduce inflammation and alleviate pain. Aim for 15-20 minutes of icing several times a day, especially after activities that may aggravate the condition.

- Heat Therapy: After the initial inflammation has subsided (usually after a few days), applying heat can help relax and loosen tissues and stimulate blood flow to the area.

- Over-the-Counter Pain Relief: Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen can help manage pain and reduce inflammation. However, be cautious with prolonged use and consult your physician if you have any underlying health issues.

- Physical Therapy: If the pain persists, consider consulting a physical therapist. They can provide targeted exercises to strengthen the muscles around the knee, improve flexibility, and enhance overall function. This can also help prevent future injuries.

- Monitoring: Keep an eye on the bump and any changes in symptoms. If the pain worsens, or if you notice swelling, redness, or increased warmth around the area, it would be prudent to seek further evaluation from an orthopedic specialist.

3. When to Seek Further Medical Attention: If conservative measures do not lead to improvement within a few weeks, or if you experience significant pain, swelling, or instability in the knee, further diagnostic imaging (like an MRI) may be warranted to assess the underlying structures more thoroughly. This can help rule out any serious conditions such as tears in the cartilage or ligaments.

In conclusion, while the bump on your knee may be concerning, it is often manageable with conservative treatment. However, staying vigilant about your symptoms and seeking professional advice when necessary is crucial for optimal recovery and to prevent further complications.

Similar Q&A

Understanding Knee Pain: Causes and Solutions for Bump on Left Knee

My left knee has a slight protrusion, and sometimes it feels a bit sore when pressed. I also cannot squat down or kneel.

Dr. Shi Guozheng reply Orthopedics
Knee pain and difficulty squatting may be related to issues with the patella, or it could be due to inflammation of the ligaments or tendons around the knee joint, which restricts joint movement. A prominent patella may be associated with trauma, and it is also important to consi...

Understanding Knee Bumps: Causes, Symptoms, and Treatment Options

I have a lump that appears on my left wrist when I bend it in a certain way, and it can be quite painful at times. I had an X-ray, and the doctor said there are no issues with the bones, but sometimes after playing basketball, it hurts when I try to bend it. This has only started...

Dr. Yang Nanping reply Orthopedics
Hello: This situation is usually caused by excessive pulling of the patellar ligament during the developmental phase, resulting in a noticeable prominence of the proximal tibia. Generally, no special treatment is required. During painful episodes, reducing activity, applying ice,...

Understanding Knee Bumps: Causes, Symptoms, and Treatment Options

Hello, Doctor! When I was in elementary school, I fell while playing sports, and shortly after, I felt a bone protruding from my knee. Since it didn't hurt, I didn't see a doctor. However, when I became aware of the bone protrusion, it became very painful when I knelt d...

Dr. Shen Boquan reply Orthopedics
Hello Ms. Dai, I am unsure whether your current discomfort is due to pain or bone protrusion. Pain from bone protrusion can be alleviated through rest or anti-inflammatory pain medications. Surgical removal may be necessary to address the protrusion. Avoiding kneeling or squattin...

Understanding Knee Discomfort: Causes and Treatment Options

Hello, Doctor! Over the years, my knee has been injured multiple times due to motorcycle riding and sports. I thought it was just external injuries and paid little attention to it, and it seemed to recover without issues. However, three years ago, while jogging, my right knee sta...

Dr. Shi Guozheng reply Orthopedics
It is possible that there is an issue with the patellar cartilage. An X-ray can be taken at the hospital to examine the relative position of the patella and the femoral joint, as well as to check for any lesions on the patella. Platelet-rich plasma (PRP) is more effective for the...