Differential Diagnosis for Right Knee Pain from Climbing Too Much

• Single Most Likely Diagnosis
  • Patellofemoral Pain Syndrome (PFPS): This is the most likely diagnosis due to the repetitive stress and strain on the knee joint from climbing, which can cause irritation of the cartilage under the kneecap, leading to pain.
• Other Likely Diagnoses
  • Medial Meniscus Tear: Climbing can put excessive stress on the menisci, leading to tears, especially if the individual lands awkwardly or twists their knee.
  • Iliotibial (IT) Band Syndrome: The repetitive bending and straightening of the knee while climbing can cause friction and irritation of the IT band, leading to pain on the outside of the knee.
  • Quadriceps or Patellar Tendonitis: Overuse from climbing can lead to inflammation of the tendons connecting the quadriceps muscle to the kneecap or the kneecap to the shinbone.
• Do Not Miss Diagnoses
  • Osteonecrosis of the Knee: Although less common, osteonecrosis (death of bone tissue due to lack of blood supply) can occur due to trauma or repetitive stress, and missing this diagnosis could lead to severe consequences, including collapse of the bone.
  • Septic Arthritis: An infection within the joint, which could be introduced through a cut or scratch, is a medical emergency requiring prompt treatment to prevent joint destruction.
  • Knee Fracture: A fracture, especially of the patella or tibial plateau, could occur from a fall while climbing and would require immediate medical attention.
• Rare Diagnoses
  • Osgood-Schlatter Disease: Although more common in adolescents, this condition, characterized by inflammation of the growth plate at the top of the shinbone, could be seen in young adults who climb excessively.
  • Plica Syndrome: This condition involves irritation of the synovial folds within the knee joint, which can cause pain and stiffness, and could be exacerbated by climbing activities.