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Sports Medicine

Knee Pain

02/22/2011

Question:

Over a year ago, I knocked my knee on the sharp corner of a low wooden table. The pain was like a bruise and then went away, leaving a hard pea-sized lump on the inner edge of my right knee cap. This very occasionally hurt if I happened to kneel on it, but was not really a problem.In the past month however, the "spot" has become very sensitive to touch and appears to `stretch` across the kneecap to the outer edge as well. I now creates a lot of pain if I kneel, even on a soft surface, or bump the area ....even just brushing lightly as when applying moisturizer. Following an X-ray which showed NO problems,I have had 5-6 sessions of Ultrasound with a Physiotherapist, but honestly can detect no improvement (yet).The pea-sized `spot` is still the most tender spot to touch. Note that I can bend and walk up and down stairs and there does not appear to be any swelling etc. Can you advise me on the best course of action please??

Answer:

The best course of action requires an accurate diagnosis, which is based on a thorough medical history and physical examination by your physician and if necessary, consultation with a musculoskeletal specialist (a physician who specializes in physical medicine, orthopedics, or family medicine).

Your symptoms may or may not be due to a form of prepatellar bursitis, or perhaps a symptomatic "neuroma." Regardless, from your description, your symptoms may have what's referred to as a "neuropathic component", which can benefit from any of a number of oral and/or topical medications which can be discussed with your physician, as well as physical therapy treatments. If there's been no definite improvement despite this many ultrasound treatments, there are other treatments including desensitization therapies which your therapist may and should use.

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Response by:

Brian L Bowyer, MD Brian L Bowyer, MD
Clinical Associate Professor
Physical Medicine & Rehabilitation
College of Medicine
The Ohio State University