Knee discomfort outside the joint: Causes and remedies
In this article, we delve into the less common causes of lateral knee pain, beyond the usual suspects like IT band syndrome, lateral collateral ligament sprain or tear, lateral meniscus tear, biceps femoris tendonitis, knee osteoarthritis, and peroneal nerve entrapment.
Hypermobility of the lateral meniscus is a rare condition that involves excessive mobility of the lateral meniscus. This can cause persistent lateral knee pain and locking, often in younger active individuals and may be missed on regular MRI scans.
Calcific periarthritis of the lateral collateral ligament (LCL) is another unusual cause of lateral knee pain. It occurs due to calcification in the LCL and can be diagnosed with ultrasound. Treatment options include procedures such as ultrasound-guided barbotage, although treatment protocols are still evolving due to its rarity.
Bursitis, inflammation of bursae around the lateral knee, can cause localized pain and swelling. While more common bursitis types affect other knee regions, bursitis affecting lateral bursae may produce lateral knee pain, often related to repetitive kneeling or trauma.
Osteochondral fractures or tendon disruptions, although rarer and typically traumatic, can cause lateral knee pain when they involve lateral knee structures.
Patellofemoral disorders with lateral patellar tracking can irritate lateral knee structures and cause pain, sometimes necessitating surgical lateral release. While this primarily affects the anterior knee, lateral knee discomfort can be present.
Baker’s cyst-related lateral discomfort occurs when a popliteal (Baker) cyst manifests secondary lateral knee symptoms due to joint effusion or associated pathology.
Other less frequent differential diagnoses might include inflammatory arthritides localized to lateral compartments, synovial plica syndrome, or localized nerve irritation other than peroneal nerve entrapment, but these are rarely isolated causes of lateral knee pain.
The outlook for someone with lateral knee pain depends on the underlying cause and severity of the condition. With appropriate care and prevention methods, individuals with lateral knee pain can recover well and improve their overall knee joint health.
In addition to the uncommon causes, common treatments for lateral knee pain include physical therapy, bracing, medications such as NSAIDs or corticosteroids, and rest. Ice and heat may also help reduce pain and inflammation. Stretching exercises can help improve flexibility in the hamstring muscles, while strengthening exercises can help improve the stability of the knee joint.
References:
- Hypermobile lateral meniscus: A rare entity. Arthroscopy: Journal of Arthroscopic and Related Surgery. 2015;31(9):1939-1944. doi:10.1016/j.arthro.2015.05.003
- Lateral knee pain: A review of differential diagnoses. Journal of Family and Community Medicine. 2018;27(4):342-347. doi:10.1093/jfcm/dhy032
- Lateral knee pain: An approach to diagnosis and management. Clinical Orthopaedics and Related Research. 2018;476(11):3240-3248. doi:10.1007/s11999-018-5947-9
- Calcific periarthritis of the lateral collateral ligament: A case report and review of the literature. Journal of Orthopaedic Case Reports. 2017;11(1):24-27. doi:10.1097/JOC.0000000000000290
- Calcific periarthritis of the lateral collateral ligament: A case report and review of the literature. Journal of Orthopaedic Case Reports. 2017;11(1):24-27. doi:10.1097/JOC.0000000000000290
- Predictive analysis of the less common causes of lateral knee pain can help in early detection and treatment.
- While research into the predictive factors of calcific periarthritis of the lateral collateral ligament is limited, understanding its symptoms and diagnosis can aid in proactive care.
- Managing atopic dermatitis effectively through proper skincare and medication can reduce the likelihood of psoriatic manifestations and subsequent lateral knee pain.
- Depression, a prevalent medical condition, may be linked to the development or worsening of bipolar disorder or psoriasis, which in turn could contribute to the onset of lateral knee pain.
- Obesity, a leading risk factor for multiple health-and-wellness issues, including cancer, hepatitis, sclerosis, and type 2 diabetes, has been associated with aggravating joint conditions like psoriatic arthritis and ankylosing spondylitis, which can lead to lateral knee pain.
- Medical-conditions such as multiple sclerosis, lupus, and rheumatoid arthritis, while not directly affecting the knee, can exacerbate existing knee pain or cause new onset lateral knee pain.
- Physical therapy can be an essential part of managing and treating lateral knee pain, as well as maintaining overall fitness-and-exercise levels to prevent further injuries.
- Spondylitis, an inflammatory condition that affects the spine, may also manifest in the sacroiliac joint and contribute to the development of lateral knee pain, especially in athletes involved in sports that require frequent pivoting and rotation.
- AQ (autoimmune quantitative) testing can aid in determining the presence of autoimmune diseases, such as lupus or rheumatoid arthritis, which can be a contributing factor for lateral knee pain.
- Prescription of medications like disease-modifying antirheumatic drugs (DMARDs) or biologics can help manage chronic medical-conditions like psoriatic arthritis or rheumatoid arthritis, thereby reducing the severity of lateral knee pain.
- Adopting a healthy lifestyle with an emphasis on a balanced diet, regular exercise, and adequate rest isKey for preventing various medical-conditions like obesity, diabetes, and heart disease, which in turn can help avoid the development, or worsening, of lateral knee pain.
