Is It Periosteal Edema? Knee Pain After Injury

Is it periosteal edema?

In February, I injured my left knee while practicing Taekwondo, resulting in an inability to exert force or bend my entire left leg, which became very stiff.
The doctor diagnosed it as a simple soft tissue injury and advised two months of rest.
By May, I felt healed and played basketball, but afterward, I experienced stiffness in my knee again, as if the joint lacked lubrication.
Additionally, there was swelling in the soft tissue around the knee, similar to before.
It has been two weeks now, and the condition has only slightly improved.
A doctor in the UK (where I am currently studying) mentioned that there is fluid in my knee.
Could this be periosteal edema, and how should I manage it? I would appreciate your guidance on these issues.
Thank you!

Huang, 20~29 year old female. Ask Date: 2002/05/31

Dr. Xu Xianda reply Neurosurgery

Mr.
Huang's issue falls within the orthopedic domain, so it will be addressed by orthopedics.
Swelling in the left knee due to injury is a common problem, which may involve bleeding into the joint at the time of injury; the blood will eventually be reabsorbed and turn into fluid.
Joint swelling for a period of time is a natural phenomenon.
If the amount of swelling is significant, aspiration of the joint fluid may be considered.
If there are symptoms of pain, medication treatment is necessary.
Typically, improvement will occur after some time; however, if there is no progress, it is important to consider whether there is damage to the intra-articular structures, in which case a visit to a physician is required.
Orthopedic Surgeon Dr.
Shih Kuo-Cheng, Deputy Director, 6.12.

Reply Date: 2002/05/31

More Info

Knee pain following an injury, especially after engaging in sports like taekwondo and basketball, can be quite complex and multifactorial. Based on your description, it seems that you might be experiencing a condition related to periosteal edema, which is swelling of the periosteum—the dense layer of vascular connective tissue enveloping the bones except at the surfaces of the joints. However, it's essential to consider other potential causes of your symptoms as well.

Understanding Your Symptoms
1. Knee Stiffness and Pain: The stiffness and inability to bend your knee could indicate a few issues. After an injury, the body often responds with inflammation, which can lead to swelling and stiffness. This is particularly true if there is any damage to the soft tissues, such as ligaments or cartilage, which can occur during sports activities.

2. Fluid Accumulation: The mention of "liquid in the knee" suggests that you may have developed joint effusion, which is an accumulation of fluid in the knee joint. This can occur due to inflammation, injury, or irritation of the joint structures. The presence of fluid can lead to increased pressure within the joint, contributing to pain and stiffness.

3. Periosteal Edema: If the injury involved a bone bruise or trauma to the periosteum, it could indeed lead to periosteal edema. This condition is characterized by localized swelling and tenderness over the affected bone. It often resolves with rest and appropriate management.

Management Strategies
1. Rest and Activity Modification: Given that your symptoms worsened after playing basketball, it is crucial to allow your knee adequate time to heal. Avoid high-impact activities that can exacerbate your condition. Instead, consider low-impact exercises such as swimming or cycling, which can help maintain fitness without putting undue stress on your knee.

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

3. Compression and Elevation: Using a compression bandage can help manage swelling, and elevating your leg can also assist in reducing fluid accumulation in the knee.

4. Physical Therapy: Engaging in physical therapy can be beneficial. A physical therapist can provide you with exercises to improve range of motion, strengthen the muscles around the knee, and enhance overall stability. They can also guide you on proper techniques to avoid re-injury.

5. Medication: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) can help manage pain and inflammation. However, consult with a healthcare professional before starting any medication to ensure it is appropriate for your situation.

6. Follow-Up with a Specialist: If your symptoms persist or worsen, it may be necessary to consult an orthopedic specialist. They may recommend imaging studies, such as an MRI, to assess for any underlying injuries to the ligaments, cartilage, or other structures within the knee.

Conclusion
In summary, while periosteal edema could be a contributing factor to your knee pain and stiffness, it is essential to consider the broader context of your injury and symptoms. Proper management, including rest, ice, compression, and possibly physical therapy, is crucial for recovery. If your condition does not improve, seeking further evaluation from a healthcare professional is advisable to rule out more serious injuries and to receive tailored treatment. Remember, listening to your body and allowing it to heal is vital for a successful return to sports and activities.

Similar Q&A

Understanding Knee Pain: Essential Tests to Diagnose Your Condition

Hello Doctor: A few years ago, my knee was injured when I fell off my bike, causing a significant swelling in the area. The doctor said that the skin and underlying tissue had separated, and there was a collection of blood and fluid inside. About a month later, when I visited Cha...

Dr. Chu Baijun reply Orthopedics
Hello: Based on the symptoms you described, it is highly likely that your knee is experiencing a hematoma and inflammation in the prepatellar bursa following an injury. Currently, the presence of scar tissue may be causing pain when kneeling, as well as soreness after prolonged w...

Understanding Knee Injuries: Pain and Swelling After an Accident

After a car accident, it has been nearly a month since my knee injury, and although I had an X-ray that showed no bone issues, I have recently noticed intermittent soreness in my injured left leg over the past two days. Is this normal? Additionally, the wound site on my knee cont...

Dr. Li Zhonghuai reply Surgery
Hello! "The X-ray showed no issues with the bones." Has the left foot been X-rayed? If the bones are fine, the main concern is soreness after a bruise, and taking vitamin B12 should help. "The tissue fluid is continuously oozing from the wound on the knee, and ther...

Knee Injury After Bike Accident: Symptoms and Treatment Insights

Hello Doctor, I am really worried... About five days ago, I fell off my bike and injured my knee. At that time, there was an abrasion, redness, and swelling, and my knee was shaking and painful, making it difficult to stand straight. I went to the emergency room, where they took ...

Dr. Huang Junxiong reply Surgery
Knee joint injuries are often accompanied by damage to the intra-articular cruciate ligaments and menisci, leading to instability and early degeneration. Please visit our orthopedic sports medicine department for diagnosis and treatment.

Understanding Knee Pain: Possible Injuries and Symptoms Explained

Hello, Director. Last month, I inquired about a related issue (link below: https://adoctor.tw/article/70763 &SortBy=&PageNo=1). Today, I have obtained new clues: I am unable to kneel, and there is severe pain in my knees. When my knees are fully extended or bent, I hear a...

Dr. Shi Guozheng reply Orthopedics
When the periosteum of a joint is injured, there may be a sound when the bone moves past it. This is not a major concern and will typically resolve over time. As long as there is no pain, it should be fine.