Knee Pain in Adults and Adolescents: The Initial Evaluation.

摘要: Knee pain affects approximately 25% of adults, and its prevalence has increased almost 65% over the past 20 years, accounting for nearly 4 million primary care visits annually. Initial evaluation should emphasize excluding urgent causes while considering need referral. Key aspects patient history include age; location, onset, duration, quality pain; associated mechanical or systemic symptoms; swelling; description precipitating trauma; pertinent medical surgical history. Patients requiring referral generally have severe pain, swelling, instability inability to bear weight in association with acute trauma signs joint infection such as fever, erythema, limited range motion. A systematic approach examination knee includes inspection, palpation, motion strength, neurovascular testing, special (provocative) tests. Radiographic imaging be reserved chronic (more than six weeks) traumatic patients who meet specific evidence-based criteria. Musculoskeletal ultrasonography allows detailed effusions, cysts (e.g., Baker cyst), superficial structures. Magnetic resonance is rarely used emergent cases an option only when surgery considered a experiences persistent despite adequate conservative treatment. When initial physical suggest but do not confirm diagnosis, laboratory tests can confirmatory diagnostic tool.