Clinical characteristics of pain originating from intra-articular structures of the knee joint in patients with medial knee osteoarthritis

Abstract

PurposeAlthough disease progression of osteoarthritis has been well documented, pain pathophysiology is largely unknown. This study was designed with two purposes: 1) to characterize patients with knee pain predominantly originating from intra-articular structures and 2) to describe the location and pattern of their pain.Materials and methods103 patients with medial knee osteoarthritis underwent an intra-articular injection of local anesthetics (joint block). At least 70% pain relief was defined as positive for the joint block, while less than 50% as negative. Pain characteristics in patients positive for joint block were evaluated in detail using a knee pain map.ResultsSixty three knees (61%) were positive and 33 knees (32%) were negative. Patients negative for the joint block were significantly higher age, suffered for longer time, and complained more diffuse pain. Although pain at anterior medial area during walk was the most common finding, pain characteristics differed among different knee areas.ConclusionThe characteristics of joint pain are widely variable even in patients with similar radiological features. Extra-articular sources are not negligible especially in older patients with a long history of diffuse pain. Differences in pain characteristics among knee areas should be taken into account when examining the pain source.

Impact of medial versus lateral knee pain on deep tissue hyperalgesia and muscle strength

“…Although distribution patterns of pain in knee OA varies from ‘localized’ to ‘widespread’ among patients (Ikeuchi et al., ), localized medial knee pain is generally the most frequent observation. In 103 varus knee OA patients, the incidence of anteromedial knee pain during walking and joint motion was 82 and 58%, respectively (Ikeuchi et al., ). Thompson et al.…”

“…Although distribution patterns of pain in knee OA varies from 'localized' to 'widespread' among patients (Ikeuchi et al, 2013), localized medial knee pain is generally the most frequent observation. In 103 varus knee OA patients, the incidence of anteromedial knee pain during walking and joint motion was 82 and 58%, respectively (Ikeuchi et al, 2013). Thompson et al also reported that the frequency of localized medial knee pain and lateral knee pain was 56 and 43%, respectively, in 799 knee OA patients (Thompson et al, 2009).…”

“…Thompson et al also reported that the frequency of localized medial knee pain and lateral knee pain was 56 and 43%, respectively, in 799 knee OA patients (Thompson et al, 2009). However, it has not been investigated why many patients tend to feel knee pain in the medial side (Thompson et al, 2009;Ikeuchi et al, 2013) and how it affects their treatment outcome.…”

Effect of therapeutic exercise on knee osteoarthritis after intra-articular injection of botulinum toxin type A, hyaluronate or saline: A randomized controlled trial

“…formation. It often causes joint pain, swelling and dysfunction, which can affect patients' quality of life, and may lead to depression (1).…”

The role of peripheral nerve injections in the diagnosis and treatment of CRPS

“…As an example, inversion injuries of the ankle (lateral ankle sprains) can cause injury to the superficial peroneal nerve, resulting in persistent pain and CRPS symptoms [41]. Pain from degenerative joint disease (DJD) may not be purely due to intra-articular pathology therapies [42], as evidenced by the knee pain relief seen with injection and denervation of the infrapatellar saphenous nerve [43,44]. As little a 6% stretch of a nerve can cause permanent injury [45].…”