[Causes of pain in the knee joint]

Pain in the knee joint is one of the commonest complaints for which people seek an advice of different medical specialists. The aim of this study was to elucidate the cause of pain in patients with the alleged diagnosis of "osteoarthrosis" and to develop the relevant diagnostic algorithm. The study included 214patients aged from 35 to 85 years with a pain level of at least 40 mm by the visual analog scale (VAS). Results of physical and X-ray examination provided indications for further studies that were performed by ultrasonographic (40.1%), arthroscopic (52.3%), and MRT(64.2%) techniques. One third of the patients were aged women with the body mass index > 40.1 and stage 3 osteoarthrosis (OA) in whom pain was attributable to primary osteoarthrosis. The remaining patients had pain of other origin. Ultrasound studies revealed rupture of the internal lateral ligament in 3, "pes anserinus" tendinitis in 5, and synovitis in 53 patients. MRT demonstrated traumatic and degenerative meniscal tear in 102 and rupture of the anterior cruciate ligament in 7 patients. Grade 3-4 chondomalacia of the femoral condyle was diagnosed in 24 patients. There was excellent (98.6%) agreement between MRT diagnosis and arthroscopic data on lesioned intra-articular structures, articular cartilage, and subchondral bone. Arthroscopy revealed traumatic and degenerative meniscal tear in 85% patients, injured anterior cruciate ligament in 8%, signs of synovitis in 52.6%, chondromalacia of the femoral condyle in 57.6%, and isolated pathology of patellofemoral articulation in 33% of the patients.