Getting the Right Diagnosis for your Knee Pain

Learn more: watch the video or read the transcript below.

Transcript of Video: Knee Pain and Injury

Hi, I am Dr. Shawn Phelan and I’m here to talk with you about knee injuries or knee complaints. In our office we often have people coming in thinking they have arthritis or an injury involving their knee.

The first thing we need to do is determine a correct diagnosis.  So, the purpose of this video is to give you a little information and some idea of the structures involved in knee conditions and how they might be addressed.

Front view of knee

When you look at the knee itself from an anatomical standpoint it is fairly simple. The femur attaches to the tibia and the patella or knee cap sits in front. Stabilizing the patella on the outside and the inside are the medial and lateral collateral ligaments – the ligament tissue is in purple. In between the femur and the tibia is a structure called the meniscus, this is a fibro-cartilaginous type of material that acts as a cushion between the femur and the tibia.

When we look at the leg or knee from the side, what we see is the patella, or the knee cap, sitting in front of the femur and the tibia. It is connected to the musculature in the front of the leg and it is connected to the tibia via the patellar tendon.

Inside the knee what we have are the cruciate ligaments (ACL). They are called cruciate because they are in the shape of a cross. Then, in-between the femur and the tibia, again we have our meniscus. So this is the universe as far as how the knee is built and how it can be injured.

In injuries, what we will typically see is damage to the ACL or to the medial and lateral collateral ligaments.  It is possible to simply strain the medial collateral ligament and not injure the meniscus but, often when you injure the medial collateral ligament, or the ligament on the inside of the knee, you will also injure the meniscus since they are attached.

If you injure the lateral collateral ligament, or the ligament on the outside of the knee, you can often do so without affecting the meniscus because they are not attached.

You will often hear the term meniscal tear, or you will hear the term cruciate ligament tear – anterior cruciate ligament tear in particular. These are the deeper injuries within the knee. Most often when a person is having knee pain and comes to our office, it is usually because they have inflammation of the musculature attaching to the knee cap or they’ve got inflammation to the patellar tendon, which are both superficial structures. That is fairly easily dealt with if we work with the inflammation in these structures.

Deep inside the knee, the cruciate ligaments can be injured during trauma. This is typically going to require an MRI and a referral to physiotherapy or possibly to a surgeon for repair of that structure.

The meniscal injuries can come in a number of different forms. They can simply come in the form of small cracks and tears due the trauma or degeneration or they can be torn straight through. You can also get what are called bucket-handle tears, where a little piece of the meniscus actually peels backwards and kind of flip-flops around. That is where the knee will lock and click and cause problems intermittently.

I have talked about many different conditions some of which require surgical interventions or physical therapy. Other conditions may just require a look at the feet, or their daily lifestyle habits.

The most important thing a person with knee problems needs is a good diagnosis. If you come to see us we will help provide you with a proper diagnosis, and if needed, proper treatment or a timely referral.

If you would like further information on knee pain or problems, please go to our website,  To make an appointment to be examined at our office, please get in contact with us by calling (919) 562-0302. We would be happy to help you. Thank you.