History (knee joint)

The following topics are helpful when asking about knee problems:

• the patient's age and sex
• pain:
  • site, radiation, quality, duration, exacerbating and relieving factors
  • attempt to distinguish between mechanical pain - often well-localised, and inflammatory or degenerative pain which is more diffuse
• trauma:
  • any history of previous injury to the affected knee
  • note the degree of force and its direction
• stiffness
• swelling:
  • particularly time of onset in relation to injury: haemarthroses occur immediately, whilst post traumatic effusions later
• locking:
  • inability to fully extend the knee. May be due to the catching of a torn meniscus.
  • ask the patient to show the position the knee is in when it locks
  • ask how locking is produced and relieved
• giving way:
  • when going down stairs or when jumping from a height, indicative of patellar dislocation, cruciate ligament tears, loss of full knee extension, and quadriceps wasting
  • upon twisting or walking upon uneven ground, indicative of meniscal injuries
• deformity:
  • genu varus or valgus
• functional impairment:
  • stairs
  • walking distance
  • home circumstances