The Common Vein Copyright 2009

Author John Udall MD

Definition

Referred pain to the knee is a common problem that can fool practitioners and lead to misdiagnosis.  Referred pain is characterized by pain felt at the knee which originates from another body part.  

Referred pain to the knee most commonly originates from problems associated with the hip, but can also be caused by pain generators within the spine.  The anterior branch of the obturator nerve lies close to the hip joint and then travels down towards the knee.  Any irritation at the hip joint can lead to referred pain at the knee.  Sometimes the hip will be asymptomatic while the knee is the only body part which hurts.  This is a common scenario with slipped capital femoral epiphysis of the hip in the pediatric population which can cause a patient with knee pain to be sent out of the emergency room prematurely since x-rays and exam of the knee are negative and the hip is overlooked.  

 

Diagnosis is suspected clinically by a negative knee exam and imaging studies but a positive exam or imaging studies of the hip or spine.

Imaging includes the use of plain x-rays to evaluate the hip and spine and occasionally a MRI.

Treatment options depend on the true origin of the pathology.

References

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