Inner Knee Swelling: Degeneration or Malignancy?

Swelling on the inner side of both knees?

Hello, doctor.
My left knee has approximately grade 2 degeneration, while my right knee is around grade 3 to 4.
There is a protruding mass on the inner side of both knees; the swelling on the left knee is smaller, and the right knee is larger.
Besides the swelling, there is no redness, no heat, no external wounds or ulcers, and there is no pain, only pain behind the knee and a cracking sound.
The swelling on the inner side of both knees has been present for over 10 years, but there was no significant degeneration in the knees ten years ago, and the swelling has slightly increased.
Could you please tell me if this swelling on the inner side of the knees is caused by knee degeneration, or could it be a malignant bone tumor? Thank you.

Mimi, 50~59 year old female. Ask Date: 2023/04/18

Dr. Wang Shouji reply Orthopedics

Hello, based on your statement, the likelihood of knee arthritis is higher and has been present for several years, while the chance of a malignant bone tumor is low.
If you have any questions, please consult the orthopedic outpatient clinic.
Changhua Hospital cares about your health.
Wang Shou-ji.

Reply Date: 2023/04/18

More Info

When it comes to knee swelling, particularly on the inner side, it is essential to consider various factors that could contribute to this condition. Based on your description, it seems that you have been experiencing swelling in both knees for over a decade, with the left knee being smaller than the right. You also mentioned that there is no redness, heat, or pain, except for some discomfort behind the knee and a "clicking" sound.
Given that you have been diagnosed with grade two degeneration in your left knee and grade three to four in your right knee, it is likely that the swelling you are experiencing is related to degenerative changes rather than malignancy. Osteoarthritis, which is a common form of arthritis, often leads to the development of bone spurs and synovial fluid accumulation, resulting in swelling. The absence of pain and other inflammatory signs such as redness or warmth further supports the idea that this is more likely a degenerative issue rather than a malignancy.

However, it is crucial to differentiate between benign conditions and potential malignancies. In cases of bone tumors, symptoms often include localized pain, swelling, and sometimes systemic symptoms like fever or weight loss. Since you have not experienced these symptoms, the likelihood of a malignant process is lower.
The "bump" you are feeling on the inner side of your knees could be due to several factors, including:
1. Baker's Cyst: This is a fluid-filled cyst that can develop behind the knee, often associated with knee joint issues. It can cause swelling and may be palpable as a lump.

2. Osteophytes: These are bone spurs that can form due to degenerative changes in the joint. They can lead to swelling and may be felt as a lump.

3. Synovial Thickening: In response to chronic irritation or inflammation, the synovial membrane may thicken and produce excess fluid, leading to swelling.

4. Meniscal Cysts: These can occur due to tears in the meniscus and may present as swelling on the inner side of the knee.

5. Ligamentous or Tendinous Issues: Conditions affecting the ligaments or tendons around the knee can also lead to swelling and may present as a palpable mass.

Given that you have a history of knee degeneration, it is advisable to consult with an orthopedic specialist. They may recommend imaging studies, such as an MRI or ultrasound, to assess the soft tissues around the knee and to rule out any significant abnormalities.
In conclusion, while the swelling in your knees is likely related to degenerative changes, it is essential to have a thorough evaluation to rule out any other potential causes, including malignancy. Regular follow-ups and imaging can help monitor the condition and ensure that any changes are addressed promptly. Always consult with your healthcare provider for personalized advice and treatment options based on your specific situation.

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