Brief Anatomy Of The Knee
The knee is a vulnerable joint that bears a great deal of stress from everyday activities, such as lifting and kneeling, and from high-impact activities, such as jogging and aerobics.
The knee is formed by the following parts:
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Tibia.;This is the shin bone or larger bone of the lower leg.
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Femur.;This is the thighbone or upper leg bone.
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Patella. This is the kneecap.
Each bone end is covered with a layer of cartilage that absorbs shock and protects the knee. Basically, the knee is 2 long leg bones held together by muscles, ligaments, and tendons.
There are 2 groups of muscles involved in the knee, including the quadriceps muscles , which straighten the legs, and the hamstring muscles , which bend the leg at the knee.
Tendons are tough cords of tissue that connect muscles to bones. Ligaments are elastic bands of tissue that connect bone to bone. Some ligaments on the knee provide stability and protection of the joints, while other ligaments limit forward and backward movement of the tibia .
How Are Blood Clots Found And Diagnosed
The first step in making the diagnosis of a blood clot is talking to the patient and family to understand the situation. The location of the blood clot and its effect on blood flow is what causes symptoms and signs. If a blood clot or thrombus is a consideration, the history may explore risk factors or situations that might put the patient at risk for forming a clot.
Venous blood clots often develop slowly with a gradual onset of swelling, pain, and discoloration. Symptoms of a venous thrombus will often progress over hours.
Arterial thrombi occur as an acute event. Tissues need oxygen immediately, and the loss of blood supply creates a situation in which symptoms begin immediately.
Arterial thrombi occur as an acute event. Tissues need oxygen immediately, and the loss of blood supply creates a situation in which symptoms begin immediately.
There may be symptoms that precede the acute artery blockage that may be warning signs of the potential future complete occlusion of the blood vessel.
- Patients with an acute heart attack may experience angina or chest discomfort in the days and weeks prior to the heart attack. It is important to remember that women may experience atypical and non-specific symptoms as part of their angina equivalent, including fatigue and malaise.
- Patients with peripheral artery disease may have pain with walking
- A TIA in which the symptoms resolve without treatment may precede a stroke.
What Is The Treatment For Claudication
There are two main ways to treat claudication: medication and a surgical treatment, called revascularization.
Medication therapies are often used initially as they are non-invasive. The two most commonly used medications include:
- Cilostazol reduces the pain of intermittent claudication by widening the arteries, thereby improving the flow of blood and oxygen to the legs.
- Pentoxifylline decreases the “stickiness” of blood and thereby improves its flow through arteries. This increases the flow of blood and oxygen to muscles.
There are several drugs being investigated to treat claudication. These medications are not yet approved for use in treating this condition. These medications include:
- ACE inhibitors
- Antichlamydophila therapy – roxithromycin
- Defibrotide
- Prostaglandins
A surgical procedure called a revascularization is used in patients who do not respond to medications. There are two types of revascularization procedures: endovascular and surgically grafting or bypassing the artery.
- Endovascular procedures include:
- Angioplasty: A balloon is placed in the blocked area and inflated to widen the diameter of the artery and increase blood flow
- Stenting: Wire mesh used to hold a blood vessel open after angioplasty and prevents scar tissue from narrowing the blood vessel
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What Is The Prognosis And Treatment For Patients With Intermittent Claudication
The prognosis of claudication is generally favorable with treatment. Without treatment, 26% of patients worsen over time. Over 5 years, 4% to 8% will progress to require a revascularization procedure.
The underlying cause of claudication, peripheral vascular disease, does put patients at risk for other atherosclerotic diseases. A finding of claudication or peripheral artery disease should be considered a warning sign of other potential atherosclerotic blockages in the body.
Get Rid Of Your Hip And Knee Pain With Our Safe And Effective Methods
Your legs are areas in the body where several muscles, tendons, and joints are joined together to help you achieve complex movement. If there is damage and pain in these areas, it can be difficult to perform daily activities. There are several specific ways that HealthQuest Physical Therapy can help can help relieve leg, hip and knee pain.;
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What Else Could It Be
If you are still not sure what is causing your severe knee pain, visit the knee pain diagnosis section where we help you work out what is going on by thinking about the location of the pain .
Alternatively, in the knee symptoms guide we look at other symptoms typically linked with knee pain such as pain when running or bending, knee locking, sharp pain or pain on the stairs. And remember, if you are suffering from severe knee pain, get checked out by your doctor.
Pain Behind The Knee: Symptoms
Each case of pain behind the knee is different. However, there are some typical signs and symptoms doctors have identified, including the ones listed below.
- Inability to put weight on knee
- Reduced range of motion in knee joint
- Stiffness
- Swelling
- Pain when trying to stretch the leg
There are some symptoms that can be an indication of a life-threatening health problem. For example, bruising on the back of the knee or calf, difficulty breathing, redness behind the knee of one leg, warmth behind the knee of one leg, and painful swelling can be signs of something serious.
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Leg Swelling: Symptoms & Signs
- Medical Author: William C. Shiel Jr., MD, FACP, FACR
Medically Reviewed on 9/10/2019
Leg swelling generally occurs because of an abnormal accumulation of fluid in the tissues of the lower extremity. The medical term for leg swelling from excessive fluid in the tissues is peripheral edema. Persisting indentation of a swollen leg after pressure from a finger is known as pitting edema.Common causes of leg swelling include salt retention, cellulitis,congestive heart failure, venous insufficiency, pregnancy, and medication side effects. Less common causes of leg swelling include blood clots in the leg , parasite infection, lymphedema, liver disease and cirrhosis, kidney disease and nephrotic syndrome, broken ankle, broken leg, and diseases that cause thickness of the layers of skin, such as scleroderma and eosinophilic fasciitis. In these diseases, the leg swelling is typically characterized by nonpitting edema. When leg swelling occurs for unknown reasons, it is referred to as idiopathic edema.
Symptoms that can be associated with leg swelling include
Other causes of leg swelling
- Idiopathic Edema
- Leg Vein Obstruction
What Are The Symptoms Of Knee Pain In Teens
Symptoms depend on whats causing your teens knee pain.
Anterior knee pain:
- Pain begins gradually; worsens with activity.
- Dull, aching pain behind the kneecap, below the knee or on sides of the kneecap.
- Pain flares and grinding sensation with repeat knee bending .
- Thigh muscle weakness .
- Knee buckles .
Trauma to knee:
- Popping, clicking, crackling in the knee when bending .
- Knee that locks or buckles.
Osgood-Schlatter:
- Pain on the bony prominence.
- Pain that varies and gets worse during or just after the activity.
- Reduced range of movement.
- Pain, tenderness and swelling at the bottom of the kneecap.
- Balance problems.
- Trouble putting weight on the affected leg; limps first thing in the morning.
- Redness, swelling, warmth, stiffness and soreness in joints, including the knee.
- Symptoms come and go.
- Dull ache, stiffness and swelling at the knee.
- Joint clicking.
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Nighttime Knee Pain In Adolescents
Many teenagers and adolescents suffer from a condition thats called anterior knee pain. This causes pain in the front or center of the knee and can often be worse at night.
Doctors from the American Academy of Orthopedic Surgeons describe this type of knee pain as dull and achy. The pain may come on gradually, and physical activity can make the knee pain worse. The other symptoms of adolescent anterior knee pain include:15
- Popping noises in the knee when climbing stairs
- Nighttime knee pain
- Pain when bending the knee
- knee pain during intense physical activity
What To Know About Pain From Hip To Knee On Outside Of Leg
Your knees and hips can get âperishable and torn;â Cartilage covers your joints and lets them fly well. Over time, it can wear out, especially in the knee and hip joints. The result is that the bones of the joints rub against each other without adequate compression. This is called osteoarthritis .
The first sign you have of OA hippo is often stiffness in your groin or thigh; You may also notice pain in your groin, thigh, or buttocks while exercising. It can get worse in the morning. If your OA is in its early stages, regular rest does not make you feel better.
The first sign of OA of the knee is often pain and stiffness; As a waist problem, it usually hurts in the morning. You may find that your knees are bent or bent as you walk. Eventually it starts to hurt and you may have trouble calming down together. You may feel bad when you kneel or climb up and down stairs.
You can reduce OA at home; Make sure you get enough rest. Although it is important to stay alive, give your limbs a rest when they are injured. You can also try acetaminophen and anti-inflammatory drugs like ibuprofen or naproxen if your doctor says these are safe for you. Provides immediate relief for the pain of weak arthritis.
You can reduce pain and stiffness if you lose weight; Excess weight puts extra stress on your knees and hips. Doctors say that every 10 pounds you lose can reduce your arthritis pain by 20%.
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Warning Signs Of More Serious Knee Problems
In some instances, knee pain can indicate more serious problems. These problems might include, fractures, dislocations, infection, or severe nerve compression .
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Fractures of the knee can be caused by a direct hit, fall or accident but sometimes can occur with minimal or no trauma. Spontaneous fractures usually occur in elderly people with osteoporosis or those who may be taking steroid medications that weaken the bone.
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A dislocated kneecap can occur when the triangular bone that covers the knee slips out of place, usually to the outside of the knee.
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Infections of the knee tend to occur if patients have a weakened immune system from any cause or medical condition. Sometimes infections of the knee can occur if there is an infection elsewhere in the body. People with knee infections usually feel unwell and can have sweats and a fever.
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Nerve compression: one type of compression condition is lumbar foraminal stenosis and can cause radiating pain anywhere down into the leg, which includes the knee. Another type of nerve compression is myelopathy, where there is a dangerous compression of the spinal cord in the neck. Myelopathy could cause symptoms that might include weakness or problems with coordination in the arms, hands, legs, or even feet.
Seek urgent and specialist medical advise if you:
What Are The Causes Of Knee Pain In Teenagers
Common knee pain problems in your teenager can be generally divided into three types:
- Anterior knee pain, also called patellofemoral pain.
- Injures to ligaments and tendons of the knee or to the kneecap itself.
- Medical conditions that affect the knee.
Anterior knee pain happens when your teens kneecap is pulled out of its groove from increased pressure. Increased pressure on the knee joint is caused by:
- Abnormal hip rotation due to imbalances in muscle strength and flexibility around the hips.
- Improper training methods or equipment.
- Poor flexibility of the thigh muscles, which support the knee joint. Thigh muscle weakness or tightness.
- Overuse of the knee from repetitive bending of the knee during running, jumping, and other activities.
- Problems with alignment, for example, the kneecap not being properly aligned within the knee or having flat feet, which changes the normal gait.
Knee pain resulting from sprains, strains and tears to ligaments and tendons or injuries to other soft tissues. These conditions include:
Medical conditions that can affect your teens knee include:
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Severe Pain With Obvious Deformity
If severe knee pain is accompanied by an obvious deformity there is most likely a fracture or dislocation on one of the knee bones. If this is the case, you will usually be able to pinpoint the time it happened there will have been a fairly major trauma such as a fall, hard tackle or RTA, and you will have excruciating knee pain. Bones dont just break or dislocate without you knowing it.
When To See A Doctor For Knee Pain At Night
Its good to remember that knee pain that keeps you awake at night can impact your daily activities. Not getting enough sleep can cause irritability, depression, increase your risk of various diseases, and aggravate chronic pain.
You should visit your doctor if you keep waking up with severe, throbbing knee pain. Doctors from the Mayo Clinic recommend visiting a doctor for knee pain in the following circumstances:
- You notice swelling and redness around the kneecap
- You have significant knee pain at night and during the day
- You cant put any weight on the knee joint
- You cant get a good nights sleep because of the knee pain
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What Happens When Blood Clots Form And Travel To The Heart
Arterial thrombus
An arterial thrombus stops the blood supply to the tissues beyond the blockage, depriving cells of oxygen and nutrients. This quickly leads to tissue death. Arterial thrombus is the mechanism that causes:
- Heart attack
- Stroke ,
- Peripheral vascular disease , or
- Ischemic bowel or mesenteric ischemia
Atrial fibrillation
In atrial fibrillation , small clots may form along the walls of the atrium or the upper chambers of the heart. If one of these clots break off, it may embolize, or travel in the bloodstream to the brain, blocking an artery and causing a stroke. Other arteries also may be involved when blood clots caused by the presence of AFib dislodge to stop blood flow , including those that supply blood to the bowel. This can cause bowel ischemia and tissue death of the intestine. Clots also can affect blood supply to the extremities .
Other types of blood clots
Blood should clot anytime it becomes stagnant. This also means clots will form when blood leaks out of blood vessels.
Examples include:
When To Contact A Medical Professional
- You cannot bear weight on your knee.
- You have severe pain, even when not bearing weight.
- Your knee buckles, clicks, or locks.
- Your knee is deformed or misshapen.
- You cannot flex your knee or have trouble straightening it all the way out.
- You have a fever, redness or warmth around the knee, or a lot of swelling.
- You have pain, swelling, numbness, tingling, or bluish discoloration in the calf below the sore knee.
- You still have pain after 3 days of home treatment.;
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How Long Does Pain Behind The Knee Takes To Resolve
How long the pain behind your knees will take to resolve depends on the cause of the knee pain, its severity, treatment, and your overall health.
However, 6 to 12 weeks is generally a good timetable for conservative methods .
Knee surgeries will take longer to fully recovery and could take anywhere from 8 weeks to 12 months.
Can Knee Pain In Teens Be Prevented
Most knee pain that is caused by injury or overuse can be prevented with some attention and work by your teen, including:
- Make sure your teen wears proper shoes for the activity/sport and wears knee pads and leg guards . Replace worn out footwear and gear.
- Engage in muscle strength training exercises. Check with a trainer to make sure proper form and body alignment are being followed. Always do warm up and cool down exercises before and after workouts.
- Keep your muscles flexible by proper stretching exercises or yoga.
- Dont engage in activities that cause or worsen knee pain.
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Signs And Symptoms Of Leg Pain
Leg pain may be constant or sporadic, and it can develop suddenly or gradually. It may occur only with certain activities, or while your legs are at rest.
Depending on the underlying condition, leg pain may be accompanied by other symptoms, including the following:
- Cramping or seizing of muscles
- Tenderness
- Muscle weakness or knees buckling
- Difficulty walking
What Are The Symptoms Of Claudication
Pain and cramping in the legs is the main symptom of claudication. Pain can be sharp or dull, aching or throbbing, or burning. The severity of the peripheral artery disease, the location of the plaque, and the activity of the muscles determine the severity of symptoms and the location of the pain. Calf pain is the most common location for leg cramps. This is because the atherosclerotic plaques often begin in the arteries farthest from the heart. If the blockage or plaque formation is farther up the leg, the pain from claudication may be felt in the thigh. If the blockage is in the aorta then symptoms may include pain in the buttocks or groin or erectile dysfunction.
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