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Rheumatology

Slideshow: Presentations of Knee Pain

  • This slideshow illustrates different types of arthritis. Each slide links to the full case report for more details.

  • Klippel-Trenaunay Syndrome

    A 7-year-old girl presented with pain and discomfort in the left leg that was exacerbated by physical activity. She had been born with a port-wine stain on the left knee. As her mobility increased, she occasionally complained of discomfort in the left leg.

    At the patient’s current visit, she was noted to have 2 erythematous to bluish vascular plaques on the superior and inferior aspects of the patellar surface with subcutaneous nodular swellings and varicosities predominantly on the lateral aspect of the lower leg. Edema and hypertrophy of the left limb were apparent. 

    Read the full case report here.

  • Occupational Prepatellar Bursitis

    For 2 months, a 29-year-old man had pain and circular, soft swelling (7 × 7 cm in diameter) over the anterior left knee, superficial to the patellar ligament. Pain was minimal and associated with extension and flexion. 

    For the past 10 years, the patient had been employed laying floor tile. A history of repetitive kneeling coupled with the pain on inspection and palpation of the bursa confirmed a diagnosis of prepatellar bursitis.

    Read the full case report here.

  • Blount Disease

    A 16-year-old African American boy presented with exertional pain below his left knee that severely limited his ability to participate in sports. The patient had had bilateral bowed legs until his early school years, when the right knee straightened. For the past year, exertional pain had been present below the left knee in the epiphyseal area.

    Tibia vara, otherwise referred to as Blount disease, is responsible for the bowing of the patient’s left lower leg. The radiographs reveal beaking of the metaphysis and calcification and widening of the proximal tibial epiphyseal plate medially, which has produced a varus deformity at the knee.

    Read the full case report here.

  • Runner With Painful Swelling Behind Knee

    For several days, a 38-year-old man has had an increasingly painful swelling behind the right knee. He runs several times a week. He has hypertension but no history of trauma or periods of inactivity, and no chest discomfort or shortness of breath. He drinks alcohol occasionally but does not use tobacco or illegal drugs. 

    Examination reveals a swollen soft tissue mass in the posterior popliteal fossa and an intact popliteal pulse. Sensation is intact; range of motion is minimally reduced with knee flexion. There is no erythema or warmth.

    Read the full case report here.