Diagnosis of pain in the hollow of the knee | Pain in the hollow of the knee

Diagnosis of pain in the hollow of the knee

The search for a diagnosis begins with the anamnesis, i.e. a detailed discussion with the patient. Here, the patient should be systematically asked where exactly the pain is located, whether accompanying symptoms (such as swelling, restricted mobility, etc.) have been noticed, whether the pain occurred suddenly or continuously and increasingly, and how strong the regular physical strain is.

If a leg vein thrombosis is suspected, it is also important to clarify triggering factors such as prolonged immobilization (e.g. during air travel), nicotine consumption or medication. In many cases, the doctor can already make a suspected diagnosis on the basis of these findings. Depending on the suspicion, further diagnostic steps can be initiated if necessary.

A suspicion of meniscus damage can, for example, be substantiated by special function tests (Steinmann sign) and ultimately confirmed or ruled out by an MRI scan. Even wear-related processes such as the Baker cyst are subject to this algorithm consisting of anamnesis, physical examination and, if necessary, subsequent imaging in the form of ultrasound or MRI images. In cases of back pain radiating into the hollow of the knee and the resulting suspicion of a herniated disc, the MRI technique is also used.However, imaging of the spinal column is performed here because that is where the cause lies and the pain also originates in the hollow of the knee, as the term “radiating” nicely describes. In order to rule out a dangerous leg vein thrombosis, the medical history is followed by a physical examination, during which the doctor pays attention to circumferential differences between the two legs, overheating and reddening of the lower leg. If necessary, an ultrasound or contrast medium X-ray examination of the leg vessels may be necessary.

Duration of pain in the hollow of the knee

Due to the many possible causes of pain in the popliteal fossa, it is not possible to give a general indication of the duration of pain. Nevertheless, depending on the trigger, some guidelines can be formulated. In the case of meniscus injuries caused by an accident, surgical treatment is usually unavoidable.

However, this is a relatively minor procedure, in which the meniscus is either sutured back together or partially removed. With regard to the time of rest following the operation, the surgeon’s instructions should be followed, but they usually turn out to be surprisingly short: Often, light running training can be resumed after only 2 weeks and full fitness for sports can be achieved after 4-6 weeks. If the pain is due to wear and tear, the duration of the period of rest can be considerably prolonged in some cases, but the spectrum of pain is wide. In general, it can be said that until the pain disappears completely, no sports activities should be done at all and then only slowly and gradually increase again. If there are concomitant diseases that favour the irritation reaction of the knee joint (e.g. arthrosis, older meniscus or ligament tears), consideration should be given to treating them first as far as possible and only then to resuming sporting activities.