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Pediatric Orthopedic Surgeons treating knee pain

KNEE PAIN

 

Some of the most common causes of knee pain in kids are dislocations, fractures, sprains, and tears of soft tissues such as tendons and ligaments. Also, in some cases, injuries may involve multiple structures in the knee.

If your child needs surgery or casting, our Fracture Care Clinic opens every day and you do not need an appointment. Surgery rooms get scheduled every morning, so your child receives the care and attention they need right away.

Knee Pain

Knee PainThe common causes of knee pain in kids are traumatic knee injuries, repetitive overuse, intense physical activities such as competitive sports, etc. Some of the most common injuries that cause knee pain in kids are dislocations, fractures, sprains, and tears of soft tissues such as tendons and ligaments. Also, in some cases, injuries may involve multiple structures in the knee.

It is common for active kids to complain of knee pain even without having sustained any trauma or injury. In most cases, a change in activity level may be the onset of all the symptoms.

Different Types of Knee Injuries We Treat

Common parts of the knee that usually get injured are the distal thighbone, proximal tibia, tendons, and ligaments.

Generally, most children recover from a knee injury within a few days. Still, it is crucial to know the most common knee injuries and when to see a doctor. Let us take a look:

Knee Sprains

Sprains mean damage to the ligaments that make up the knee. Most sprains result from damaged Anterior Cruciate Ligament (ACL) or the Medial Collateral Ligament (MCL). Even any one of these ligaments can lead to severe injuries.

Signs and Symptoms 

  • Swelling and pain around the knee
  • Not able to stand or put pressure on the injured leg

Knee Strains

Just like sprains, strains are common knee injuries in children. However, in this case, the reason is damaged muscle or tendon within the knee.

Signs

Bruising around the knee and other symptoms similar to a sprain

QUESTIONS AND ANSWERS

What are the common causes of knee pain in children?
  • Growth-Related Pain: Many children experience knee pain associated with growth spurts, known as growing pains. This is typically benign and often occurs in the evenings or at night.
  • Sports-Related Injuries: Active children may experience knee pain due to injuries like sprains, strains, contusions, or fractures from sports or physical activities.
  • Overuse Injuries: Repetitive use of the knee joint, as seen in sports or activities like dance, can lead to overuse injuries, such as patellofemoral pain syndrome or Osgood-Schlatter disease.
  • Medical Conditions: Conditions like juvenile idiopathic arthritis or Lyme disease can cause knee pain in children. Infections or inflammatory conditions are less common but should be considered.
How can knee pain in children be managed at home?
  • Rest: Encourage the child to rest and avoid activities that exacerbate the pain.
  • Ice: Apply ice to the affected area for 15-20 minutes every few hours to reduce pain and inflammation.
  • Compression and Elevation: In cases of swelling, using a compression bandage and elevating the leg can help reduce discomfort.
  • Over-the-Counter Pain Relief:* Non-prescription pain relievers like acetaminophen or ibuprofen, used according to the recommended dosage, can help manage pain. Always consult with a healthcare provider before administering medication to a child.
When should I seek medical attention for a child's knee pain?
  • Persistent or severe knee pain that does not improve with rest and at-home care should prompt consultation with a healthcare provider.
  • If the child experiences significant swelling, redness, warmth, or an inability to bear weight on the affected leg, immediate medical attention is necessary.
  • Knee pain accompanied by other concerning symptoms such as fever, joint swelling, or a rash should be evaluated by a healthcare professional.
  • Any suspicion of a traumatic injury or a history of recent falls or accidents involving the knee should be assessed by a healthcare provider.

It’s essential to consider the child’s age, activities, and any underlying medical conditions when addressing knee pain. In cases of persistent or severe pain, or if there is any doubt about the cause, consultation with a pediatrician or pediatric orthopedic specialist is recommended to ensure proper evaluation, diagnosis, and management of the knee pain.

The doctors and surgeons at the Medical City Children’s Orthopedics and Spine Specialists diagnose, treat, and care for children with knee problems that create pain.

Torn Ligaments in the Knee

Ligament tears occur if a joint is overstretched or twisted. Ligaments can tear totally, or sometimes, it can be a partial tear. It could be an ACL tear or an MCL tear. An incomplete tear feels like a severe strain. But a complete tear can be as painful as a broken bone.

Common Signs 

  • Snapping, popping, or a crackling sound at the knee joint
  • Knee Pain and swelling that does not improve within 24 to 72 hours
  • Limited mobility of the joint
  • Inability to bear weight on a joint
  • Worsening Symptoms

Knee Fractures

Knee fractures mean broken or cracked bones in the knee. Also, there might be a dislocated patella or kneecap. A cast or a splint might be enough for simple fractures. However, when there are fractures along with a dislocated patella, it might need surgery to fix.

Signs

Children with knee fractures might experience intense knee pain.

Tendonitis

Active children are more prone to tendonitis. Tendonitis happens when the tendons in the knee become irritated. It is often the result of overused tendons and poor training. Treatment for tendonitis may involve medication, physical therapy, or surgery.

Sign

If the knee hurts when walking, resting, bending, or lifting – it might be tendonitis.

Patellofemoral Syndrome

Runner’s knee or patellofemoral stress syndrome is the result of knee overuse. This injury develops because of repetitive pressure between the thigh bone (femur) and the kneecap (patella). Many factors can cause a runner’s knee, such as flat feet, knock knees, muscle imbalances, improper training, wearing shoes without enough support, etc.

Symptoms 

  • There might be pain around or under the kneecap that increases during jumping, running, squatting, climbing stairs, etc.
  • A feeling of stiffness in the knee after sitting for a longer time
  • Weakness in the knees, occasional knee buckling

ACL Tear

Injury to the ACL may happen during pivoting or cutting movements, at the time of landing after jumping, blown knee, etc. When an ACL is partially or completely injured, the knee might be totally unstable, or the joint damage can worsen.

Symptoms

  • A popping sound during the injury
  • Feeling like the knee has given out
  • Knee pain and swelling within 24 hours of the injury

MCL Injury

An MCL tear usually occurs when a child suddenly twists his knee at the time of running or landing after jumping.

Symptoms 

A popping sound during the injury followed by knee pain, swelling, knee weakness, etc.

PCL Injury 

PCL (Posterior cruciate ligament) injuries usually occur with other knee damage and injuries to the nerves and blood vessels.

Symptoms 

  • Worsening swelling and inflammation
  • Instability and stiffness in the knee
  • Difficulty in walking and going downstairs

LCL Injury

An LCL ( lateral collateral ligament ) injury or tear might happen due to a direct blow to the inside of the knee, changing directions quickly or pivoting on one foot, landing badly or awkwardly from a jump, etc.

Symptoms 

  • Sore, stiff, or tender knee
  • The knee feels like it will give out
  • Your knee may lock in place
  • Limited mobility
  • Knee pain, numbness, weakness, etc.
  • You may have bruises on or around the knee.

Juvenile Arthritis

It is the most common type of arthritis among children under age 16. The symptoms are knee pain, stiffness, and swelling. Also, there might be serious complications such as joint damage, growth problems, and eye inflammation.

Symptoms 

Knee pain, swelling, stiffness, fever, swollen lymph nodes, and rash.

How We Diagnose Knee Pain and its Associated Knee Injuries 

To accurately diagnose a knee injury, our doctors ask about how it happened. Also, we know the associated symptoms. Our child orthopedic specialists will do a thorough physical exam by pressing on the knee and legs and moving them in specific ways. These tests will show the injured part of the knee.

Imaging tests that we recommend are

  • X-rays to check for bone injuries
  • A CT scan or MRI to look inside the knee

Knee Pain Treatment 

Treatment for a knee injury depends on the cause and severity. Some knee injuries only need RICE (rest, ice, compression with an elastic bandage, and elevation). However, other knee injuries may need physical therapy, bracing, or even surgery.

If only the posterior cruciate ligament is damaged, there will be no need for surgery. But, if there is a dislocated knee along with multiple torn ligaments, doctors may recommend surgeries.

Depending on the severity of the knee injury, various surgical options are available. The least invasive is arthroscopy which involves small incisions and special tools to repair the knee. Also, there is knee osteotomy, which fixes one section of the knee. The other surgical options are:

  • Plica Removal
  • Lateral Release
  • Microfracture
  • ACL Reconstruction
  • Meniscectomy
  • Meniscus Repair
  • Meniscus Transplant
  • Arthrotomy
  • Tendon Repair
  • Knee Replacements, etc.

Make an Appointment with Your Doctor

Schedule a visit to the doctor if your child got a knee injury from a particularly forceful impact or if it involves:

  • Redness and swelling
  • Tenderness and warmth around the joint
  • severe knee pain
  • Fever

Ignoring the symptoms or not seeing a doctor ASAP may further worsen the condition.

Seek Immediate Medical Attention for Knee Pain

Urgent care will be necessary if the knee pain comes from an injury and there is:

  • A deformed joint
  • Popping sound at the time of knee injury
  • Severe knee pain
  • Sudden swelling
  • Inability to bear weight

Final Words about Knee Pain

Prevention is better than cure. In other words, wearing the recommended protective equipment for sports, supportive athletic shoes, and proper strength training can help prevent serious knee injuries. It is crucial to take time to warm up and cool down during workouts. Also, children should avoid any sudden changes in the intensity of practice or workouts. It is because the knees require time to adjust to the more rigorous activities.

Bottom line: if your child’s knee hurts, it is crucial to know why. See one of our pediatric orthopedic doctors at the Medical City Children’s Orthopedics and Spine Specialists to find out what is causing the knee pain and get proper treatment. Please note that we have offices in Arlington, Dallas, Flower Mound,  Frisco, and McKinney, TX.

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Footnote:

Medline Plus: Knee Pain

 

Call 214-556-0590 to make an appointment.

Comprehensive services for children from birth through adolescence at five convenient locations: Arlington, Dallas, Flower Mound, Frisco and McKinney.