Differential Diagnosis for Bilateral Posterior Knee Pain
- Single most likely diagnosis
- Baker's Cyst: This is a fluid-filled swelling that causes a bulge and a feeling of tightness behind the knee, often associated with knee arthritis or injury. It is a common cause of posterior knee pain and can be bilateral.
- Other Likely diagnoses
- Hamstring Strain: Strains to the hamstring muscles can cause pain in the posterior aspect of the knee, especially if the strain is severe or involves the proximal (upper) part of the muscle.
- Gastrocnemius Strain: The gastrocnemius muscle is located in the calf but can refer pain to the posterior knee. Strains or tears in this muscle can cause bilateral posterior knee pain.
- Popliteus Tendinitis: Inflammation of the popliteus tendon, which is located at the back of the knee, can cause pain in this area.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Deep Vein Thrombosis (DVT): Although less common, DVT can cause pain in the posterior knee, especially if the clot is located in the popliteal vein. This condition requires immediate medical attention to prevent pulmonary embolism.
- Neoplastic Processes: Tumors, either benign or malignant, in the bones, soft tissues, or nerves around the knee can cause persistent and unexplained pain.
- Rare diagnoses
- Cystic Adventitial Disease: A rare condition where a cyst forms around the popliteal artery, leading to intermittent claudication and posterior knee pain.
- Popliteal Artery Entrapment Syndrome: A condition where the popliteal artery is compressed, leading to pain, claudication, and other symptoms in the posterior knee and calf.
- Neurogenic Causes: Such as nerve root compression or peripheral neuropathy affecting the nerves around the knee, can cause posterior knee pain, although these are less common causes.