Differential Diagnosis for Medial Knee Pain
Single most likely diagnosis
- Medial Meniscus Tear: The location of the pain and tender point, 2 inches below the tibial plateau, is consistent with the anatomy of the medial meniscus. Meniscus tears are a common cause of knee pain, especially with activities that involve twisting or bending.
Other Likely diagnoses
- Medial Collateral Ligament (MCL) Sprain: The MCL is located on the medial aspect of the knee and can cause pain in the area described. A sprain can occur from a valgus stress (a force that bends the knee inward).
- Pes Anserine Bursitis: This condition involves inflammation of the bursa located on the medial aspect of the knee, about 2 inches below the joint line, which matches the location of the tender point. It is more common in individuals with knee osteoarthritis or those who are overweight.
- Medial Tibial Stress Syndrome (Shin Splints): Although more commonly associated with pain in the lower two-thirds of the tibia, medial tibial stress syndrome can sometimes present with pain higher up, near the knee.
Do Not Miss diagnoses
- Osteosarcoma or Other Bone Tumors: Although rare, bone tumors can present with localized pain and should be considered, especially if the pain is persistent, worsening, or accompanied by other systemic symptoms like weight loss or fever.
- Infection (Osteomyelitis or Septic Arthritis): Infections in the bone or joint can cause localized pain, redness, and swelling. These conditions are medical emergencies and require prompt diagnosis and treatment.
- Deep Vein Thrombosis (DVT): DVT can cause pain and swelling in the leg, which might be perceived as knee pain. It's a critical condition due to the risk of pulmonary embolism.
Rare diagnoses
- Saphenous Nerve Entrapment: The saphenous nerve can become entrapped or irritated as it descends through the leg, potentially causing pain on the medial aspect of the knee.
- Osgood-Schlatter Disease (in adults): Typically seen in adolescents, this condition involves inflammation of the patellar tendon at its insertion on the tibial tubercle. However, it can rarely occur in adults, potentially causing pain below the knee.