Osteopathic Diagnosis of the Knee Region

Knee pain is a common presentation to primary care physicians. The diagnosis can be challenging as the pain may arise from the joint, surrounding tissues, or referred to the joint from distant structures. The differential diagnosis of knee pain is broad and categorizing the various diagnoses related to the timing (acute or chronic) is useful. A thorough understanding of pertinent anatomy, appropriate physical examination, and common problems of the knee joint are essential for diagnosis and proper management of knee pain. Exercise-based therapy is often the 1st-line management of many knee disorders, but surgical intervention is warranted for specific diagnoses.

Osteochondritis dissecans (OCD) is an orthopedic disorder characterized by the detachment of a focal segment of subchondral bone and cartilage as a result of focal aseptic necrosis. This can occur at any age, but it is most commonly seen in adolescents who participate in competitive sports. Patients can be asymptomatic or may present with joint pain, stiffness, and swelling that is worse with activity. The diagnosis can be made with imaging. Management depends on the severity, but can include restricted weight-bearing activity, physical therapy, or surgery.