Knee Pain…What’s my Diagnosis?

Written by: Noah Kaminsky,PT, DPT, SCS, CSCS

Patellofemoral (knee) disorders are among the most common conditions managed in the orthopedic and sports medicine setting. The patellofemoral joint consists of the patella (knee cap) and trochlea (femur or thigh bone).

The differential diagnosis of anterior knee pain is extensive and usually diagnosed using medical history and a physical examination. Some of the more common pathologies seen are patellar tendinopathy, IT band syndrome, and patellofemoral pain syndrome.  These injuries are more common in, but not limited to, people who participate in running or jumping activities. These pathologies are usually caused by overuse or overload.

Common knee injuries and symptoms include:

  • Patellar tendinopathy
    • Inferior knee pain
    • Tenderness around inferior patella and patella tendon
    • Common in sports involving frequent jumping
  • Iliotibial (IT) band syndrome
    • Lateral knee pain
    • Tenderness in lateral knee
    • Common in runners and bikers
  • Patellofemoral pain syndrome
    • Pain in or around the knee
    • Increased pain with increased knee flexion with weightbearing exercises

Some risk factors include abnormal alignment, abnormal biomechanics and muscle weakness.  Patellofemoral pain is treated with conservative care. This includes early reduction in symptoms, activity modification and physical therapy. If indicated, injections and imaging may be warranted.

Other differential diagnoses include Hoffa disease, lateral patellar compression syndrome, patellar instability, plica syndrome and arthritis. A thorough clinical examination will determine what tissues are involved and allow the physical therapist to prescribe appropriate exercises based on the pathology.

About the Author

Noah received his Bachelor of Science degree in Exercise Science from Ithaca College and his Doctorate of Physical Therapy from the University of Miami. He specializes in orthopaedic and sports rehabilitation and has experience treating professional and D1,D2 and D3 athletes. Noah has worked as a sports physical therapist for Raleigh Orthopaedic since 2015.  Prior to working in North Carolina, Noah worked in a sports medicine clinic in New York City.

He is a Certified Strength and Conditioning Specialist (CSCS) through the National Strength and Conditioning Association.  Noah is also an APTA board-certified Sports Clinical Specialist (SCS). He is certified in Functional Movement Screen (FMS), Kinesio Taping, and is credentialed to perform Dry Needling. Noah is also a Polestar Pilates-Based Rehabilitation Practitioner.  Noah is currently studying to become a Performance Enhancement Specialist (PES) through the National Academy of Sports Medicine. He works as the PT consultant for New York Nine baseball.