Pain along the medial or lateral joint lines may be indicative of a joint capsule tear, joint capsule irritation, meniscus tear, chondromalacia, osteochonritis dissecans, arthritis or other joint pathologies. Palpation of the joint line while performing a valgus or varus stress test will help to differentiate the area of the pain. It is also important to correlate and work with the patient to determine if this is the type of pain that they have or something that the examiner is creating. When applying a varus or valgus stress across the joint, one should place their fingers directly over the joint line to assess for joint line pain, crepitation (which may indicate cartilage damage or a meniscus tear), or joint line gapping (which may indicate a ligament injury) or pseudolaxity, which would indicate loss of articular cartilage with osteoarthitis. It is important to discern from the patient if the pain is coming from directly below one’s fingers of if it feels like it is deeper inside the joint to determine if it is a joint capsule injury, or if it is a meniscus or cartilage injury.
About the Author: Robert LaPrade, MD
Robert LaPrade, MD, PhD has specialized skills and expertise in diagnosing and treating complicated knee injuries. He has treated athletes at all levels, including Olympic, professional and intercollegiate athletes, and has returned numerous athletes back to full participation after surgeries. Recognized globally for his outstanding and efficient surgical skills and dedication to sports medicine, he has received many research awards, including the OREF Clinic Research Award considered by many a Nobel Prize in orthopedics. Dr. LaPrade is one of the most published investigators in his field, and many of the surgeries that he has developed are now performed worldwide and recognized as the “gold standard” for the treatment of complex knee injuries.