Differential Diagnosis for Knee Pain in a 24-Year-Old Female
Single Most Likely Diagnosis
- Chondromalacia Patella (Patellofemoral Pain Syndrome): This condition is characterized by knee pain that worsens when standing up from a sitting position and improves with movement. It is common in young adults, especially females, and is often related to overuse, misalignment of the patella, or softening of the cartilage on the underside of the kneecap.
Other Likely Diagnoses
- Osgood-Schlatter Disease: Although more common in adolescents, this condition can persist into young adulthood. It involves inflammation of the patellar tendon at its insertion on the tibia, causing knee pain that worsens with activity and improves with rest.
- Patellar Tendinopathy (Jumper's Knee): This condition involves inflammation of the patellar tendon, leading to knee pain that is typically worse with jumping, landing, or activities that involve deep knee bending. However, it can also cause pain when standing up from a seated position.
- Meniscal Tears or Degeneration: Tears or degeneration of the meniscus can cause knee pain, especially with weight-bearing activities or twisting motions. While less common in young adults without a history of trauma, it's still a consideration.
Do Not Miss Diagnoses
- Osteonecrosis (Avascular Necrosis) of the Femur or Tibia: Although rare, osteonecrosis can cause knee pain that worsens with weight-bearing activities. It is crucial to diagnose early to prevent collapse of the bone and subsequent arthritis.
- Infection (Septic Arthritis): Infection within the knee joint can cause severe pain, swelling, and warmth. It is a medical emergency requiring prompt diagnosis and treatment.
- Tumor (Benign or Malignant): Bone or soft tissue tumors around the knee can cause pain, especially with weight-bearing. While rare, missing a diagnosis of a malignant tumor could have severe consequences.
Rare Diagnoses
- Hoffa's Syndrome (Infrapatellar Fat Pad Impingement): This condition involves inflammation of the infrapatellar fat pad, causing anterior knee pain that can worsen with activities like squatting or climbing stairs.
- Plica Syndrome: This is a condition where the synovial folds within the knee joint become inflamed, causing knee pain and snapping sensations. It is less common and often associated with activities that involve frequent knee bending.
- Bursitis (Prepatellar, Infrapatellar, or Pes Anserine): Inflammation of the bursae around the knee can cause localized pain and swelling. While not typically the primary cause of pain that improves with movement, it could be a contributing factor in some cases.