Posterior and Medial knee pain

[naveenedin]

hello,
if you could find a palpable lump, it may correlate with osteochondritis dissecans, considering his age. google this condition, look if it fits with your patient. if thats the case physio may not be a huge help. other possible chance could be an intraarticular loose body, from the fact other lig/menisci are normal. i agree with steve, for slim chances of referred pain. Other thing u could do, is a slr and add components such as hip add and ankle DF/PF and Inv/Eve sometimes if your sural nerve is involved or stretched u may get anke pain. does his knee give way, has he got an x-ray done, just to rule out. check his pirformis length. look for resisted knee extension in mid and outer ranges, to rule out osgood schlatters. there isn't a box standard answers, treat as u go. do update pls.

[Physio Dace]

Although a little old check the hip and clear it as a potential referral site e.g. slipped epiphysis. If there are local knee signs (e.g. tenderness over fenoraml condyle and pain with loaded knee ROM) then an OCD lesion should be suspected and ruled out given his age and activity it doesn't sound like a loose body yet but it may be the early stages. Beyond that I would throroughly check the hamstrings and associated neural provocation tests as a potential source.

[Meagan]

Thanks for all the replys and wow its overwelming all the opions that i could do, and most of it i would have to research as i have a basic knowledge considering that this is my first year.

The feedback might take some time as i am working in a rural area where money is scares and the patients are not able to attend physio regularly. That is also why the subjective assessment is so poor because of the language barrier (pt speaks zulu).

Thanks again
meagan

[mIrAge]

I would be inclined to try to relate back to how the pain started in the first place. McMurray's test along with any other manual test, is not sensitive nor specific to diagnose meniscal injury. Also consider patellofemoral joint.

Good luck,
M.