Differential Diagnosis for Pain and Tenderness on the Medial Aspect of the Tibial Plateau and Medial Inferior Margin of the Patella
- Single Most Likely Diagnosis
- Medial patellofemoral ligament (MPFL) sprain or medial patellar tendinopathy: This condition is likely due to the location of the pain, which is commonly associated with injuries to the medial stabilizers of the patella or the patellar tendon itself.
- Other Likely Diagnoses
- Medial meniscus tear: Tears in the medial meniscus can cause pain and tenderness on the medial aspect of the tibial plateau due to the meniscus's location and function in absorbing shock and stabilizing the knee.
- Pes anserine bursitis: This condition involves inflammation of the bursa located on the medial aspect of the knee, where the tendons of the sartorius, gracilis, and semitendinosus muscles insert, and can cause pain and tenderness in the area described.
- Medial collateral ligament (MCL) sprain: An injury to the MCL, which is located on the medial aspect of the knee, can cause pain and tenderness in this area, especially if the injury is acute.
- Do Not Miss Diagnoses
- Osteonecrosis of the medial tibial plateau or patella: Although less common, osteonecrosis (death of bone tissue due to lack of blood supply) in these areas can cause significant pain and must be considered to avoid missing a potentially serious condition.
- Infection (septic arthritis or osteomyelitis): Infections in the knee joint or bone can cause severe pain, redness, and swelling, and it is crucial to diagnose and treat them promptly to avoid serious complications.
- Tumor: Both benign and malignant tumors can occur in the bones or soft tissues around the knee, and while rare, they must be considered in the differential diagnosis to ensure timely and appropriate treatment.
- Rare Diagnoses
- Medial plica syndrome: This is a condition where the synovial folds within the knee joint become inflamed, causing pain and stiffness, and can sometimes be associated with the described location of pain.
- Sartorius or gracilis tendonitis: Inflammation of the tendons of these muscles, which insert on the medial aspect of the tibia, can cause pain in the area but is less common compared to other diagnoses listed.