1️⃣ At the reception, a 52-year-old patient.
Height 160, weight 76kg.
Complaints of knee pain: in the morning up to 15 minutes, inside the knee, pulling. It hurts to put your legs on your legs to fall asleep, puts a pillow between your legs.
On examination: use https://pillintrip.com/ru/medicine/lustral, knees without effusion, but sharply painful in the projection of the anserine bursa (Fig. 1), the attachment points of the femoral tendons. Crepitation is not great. In analyzes, there are minimal deviations. On x-ray arthrosis 1-2 degree.
Problem: Anserite, ultrasound confirmed.
2️⃣Man 46 years old, 180cm, 78kg.
Complaints of pain and crunching in the knees: the pain intensifies in the evening, after exertion, there were injuries in the anamnesis, but, according to the words, “not serious”, sometimes the knee on the right swells a little, passes by itself in ~ 2 weeks, “walks” in the morning for 5 -10 minutes, when there is swelling in the joint – it is longer. In the last couple of months, night pains in the joint, similar to a dull toothache, have been troubling.
On examination: the knee on the right is swollen, warmer than on the left, sensitive in the projection of the joint space, under the patella, in the anterior tibial region. Crepitation on the left is moderate, on the right, not audible due to joint effusion. ESR is slightly increased. On RG arthrosis of the 2nd stage.
What’s alarming? Synovitis on the right and knee pains at night. What are we going to do in terms of additional examination? MRI. It is important to assess the condition of the bone, to exclude edema-osteitis (Fig. 2). At the same time, we will see menisci, cruciate ligaments, the thickness of the synovial membrane, articular bags.
3️⃣ Female, 32 years old, started active training a month ago: runs, squats, lunges. Before that, I did not go in for sports. She lost 3 kg, but noticed pain in the knee at the maximum points of the range of motion, a crunch when bending the knee, it became painful to jump and unpleasant to run, especially unpleasant in the area of the patella and on the outside under the kneecap (Fig. 3).
The analyzes are excellent, the Rg images are normal.
On examination: the kneecap moves outward during squatting. The diagnosis is clear.
What do all 3 cases have in common?
That formally everyone can be exposed to osteoarthritis of the knee joints.
But the reason, and hence the treatment, will be different for everyone!
Good health to you! And let the movement bring only joy !!!