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Painful snapping in rheumatoid knees

T Torisu1, S Yosida, M Takasita

  • 1Department of Orthopaedic Surgery, Oita Medical University, Japan.

International Orthopaedics
|January 1, 1997
PubMed
Summary

Rheumatoid arthritis patients can experience painful knee snapping due to solitary intra-articular masses. These masses, often located on the lateral femoral condyle, cause a distinct jumping sensation during knee movement.

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Area of Science:

  • Orthopedics
  • Rheumatology
  • Pathology

Background:

  • Rheumatoid arthritis (RA) is a chronic inflammatory disorder affecting joints.
  • Intra-articular masses in RA can cause mechanical symptoms.
  • Snapping knee is a less common but significant symptom.

Purpose of the Study:

  • To describe the clinical and histopathological features of solitary intra-articular nodular masses causing painful snapping in rheumatoid arthritis patients.
  • To investigate the location and behavior of these masses within the knee joint.

Main Methods:

  • Case series analysis of 11 knee joints in 8 patients with rheumatoid arthritis.
  • Clinical observation of mass location, size, and snapping characteristics during knee flexion/extension.
  • Histopathological examination of excised or biopsied masses.

Main Results:

  • A solitary intra-articular nodular mass was identified in 11 knee joints of 8 RA patients.
  • Masses were consistently located in the anterolateral aspect of the lateral femoral condyle.
  • Snapping occurred during specific degrees of knee flexion (15-30° or 50-60°).
  • Histopathology revealed rheumatoid nodules in 4 joints and myxomatous degeneration/collagen necrosis in 7.

Conclusions:

  • Solitary intra-articular nodular masses can cause painful snapping in the knee of rheumatoid arthritis patients.
  • The characteristic location and mechanical behavior of these masses are important diagnostic clues.
  • Histopathological findings indicate diverse origins, including rheumatoid nodules and degenerative changes.

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