Knee Pain

Definition

Knee problem not associated with recent trauma.
Services- Rheumatology

When to Refer

1. Unsure of diagnosis:
   Consider Anterior knee pain/Chondromalacia Patallae.
   Arthritis (inflammatory/osteoarthritis).
   Refered pain (hip/lumbar spine).
2. If knee locking or giving way ---> refer to Orthopaedics (Mr R. Parkinson or Mr R. Harvey)
3. Monoarthritis without trauma ---> refer to Rheumatology.
4. If knee pain significantly limits mobility (<100 yards) or gives night pain which regularly wakes the patient despite pre-sleep analgesia then refer to Orthopaedics.
   Rheumatology Referral
   

Investigations

• FBC
• ESR
• Biochemical profile
• (Urate if monoarthritis)
• Xray target area
  

Special Points

1. Please ensure synovial fluid is examined for crystals if aspiration is undertaken. Synovial rheumatoid factor is unhelpful.
2. Consider steroid injection to knees where there is an effusion, only perform once pre-referral unless significant benefit gained.

Document Information
Expiry Date: 11/04/04
Author: Kennedy Tom Dr
Organisation: Arrowe Park Hospital