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.
Robert LaPrade, MD | Minnesota Knee Specialist | Twin Cities, Minneapolis-St.Paul, Edina, Eagan
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