Knee Injuries: Symptoms, Complaints, Signs

The following symptoms and complaints may indicate knee injuries:

Leading symptoms

  • Pain
  • Instability

Other possible symptoms

  • Joint effusion
  • Joint swelling
  • Deformity

Note: A rapidly bulging knee usually presents as an acute injury with hemorrhage.

Meniscus injuries

Meniscal contusion

  • Local pressure pain
  • No joint effusion

Meniscus tear without stretch/bend inhibition.

  • Local pressure pain
  • Positive meniscus signs
  • Possibly joint effusion / joint swelling

Meniscus tear with stretching / bending inhibition.

  • Local pressure pain
  • Positive meniscus signs
  • Active/passive stretch/bend inhibition.
  • Possibly joint effusion/joint swelling.

Ligament injuries

Lateral ligament strain

  • Localized tenderness at points of attachment/progression of the ligament.

Lateral ligament rupture

  • Localized pressure pain at points of attachment/progression of the ligament.
  • Instability

Anterior cruciate ligament rupture

  • Anterior drawer phenomenon (side comparison).
  • Positive cross-band tests
  • Mostly joint effusion/joint swelling

Posterior cruciate ligament rupture

  • In lateral view: tibial head displaced dorsally (knee in lateral view).
  • Knee pain
  • Often no joint effusion

Cartilage injuries

Cartilage contusion (cartilage bruise)

  • Swelling
  • Punctate pain on exertion

Cartilage damage or flake fracture (osteochondral lesions; avulsion fracture or shear fracture).

  • Blocking phenomena
  • Joint effusion/joint swelling

Combination injuries

Complex mediolateral joint injuries (“Unhappy Triad”).

  • Severe pain
  • Instability

Luxations (joint dislocations)

Knee joint dislocation

  • Knee joint malalignment
  • Severe instability
  • Pain

Patellar luxation

  • Patellar dislocation pain – pain that occurs when the kneecap (patella) is passively moved in its femoral sliding bearing under pressure.
  • Deformed knee joint
  • Often combined with hemarthrosis (bleeding into the joint).
  • Pressure pain

Note: Snapping in the knee does not have to be from the meniscus. In one study, mechanical symptoms were equally common preoperatively in arthroscopic knee patients with and without meniscal tears.

Note: Snapping in the knee does not have to be from the meniscus. In one study, mechanical symptoms were equally common preoperatively (“before surgery”) in arthroscopic knee patients with and without meniscal tears.