Diagnosis of knee pain is based on history, physical examination by your doctor, various imaging tests (such as X-ray, CT scan, MRI, ultrasound etc.) and various lab tests. Your doctor may ask detailed history about your problem of knee pain, such as if there is any history of physical injury recently or years before, if there is any family history, if the pain is increasing or it is same for long time etc.
Physical examination for knee pain:
Your doctor may do various physical examinations such as,
- Proper inspection of your knee for any swelling, bruising, redness, warmth, pain and tenderness etc.
- Your doctor may also check the range of movements at knee joint
- Your doctor may evaluate integrity and strength of knee joints by pull on or push test.
Imaging tests for knee pain:
- Ultrasound: this is done to check if the soft tissue around knee joints are normal or not.
- CT scan: this can detect if there is any loose body inside joint space of if there is any tear in meniscus. Other bone problems may also be detected by CT scan.
- MRI scan: this can find out if there is any injury to soft tissues such as ligaments, muscles, cartilages and tendons, which a CT scan may miss.
- X-ray: X-ray can find if there is any fracture or any degenerative changes in the knee joint.
Lab tests for diagnosis of knee pain:
Various lab tests may be required to diagnose various causes of knee pain. If your doctor suspects your knee pain is due to infection, lab test can help in diagnosis of the cause of knee pain and help in management of knee pain. If your knee pain is due to gout or pseudogout they can be diagnosed by lab tests. In gout, serum uric acid will be very high and there will be uric acid crystals in the synovial fluid of knee joint. X-ray may also be helpful in diagnosis of gouty arthritis. In pseudogout, there may be crystals containing calcium in the synovial fluid, unlike uric acid crystals in gout. Small amount of synovial fluid of knee joint may have to be removed (process known as arthrocentesis) using a long needle for lab test.
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