Differential Diagnosis for Knee Soreness at Rest
- Single most likely diagnosis
- Osteoarthritis: This is the most common cause of knee pain, especially in older adults. Knee soreness at rest is a characteristic symptom, particularly after periods of inactivity or at night, due to the increased pressure and stiffness in the joint.
- Other Likely diagnoses
- Bursitis: Inflammation of the bursae, which are fluid-filled sacs that cushion the joints, can cause knee soreness, especially at rest. Prepatellar bursitis, for example, is known as "housemaid's knee" and can occur from prolonged kneeling.
- Tendinitis: Inflammation of the tendons, which connect muscles to bones, can cause pain and soreness, particularly at rest. This is common in individuals who engage in repetitive activities or sports.
- Meniscal tears: Tears in the cartilage of the knee joint can cause pain, especially with twisting motions, but can also lead to soreness at rest due to the instability and inflammation in the joint.
- Do Not Miss diagnoses
- Septic arthritis: This is an infection within the joint space, which can cause severe pain, swelling, and soreness, even at rest. It is a medical emergency that requires prompt treatment to prevent joint destruction.
- Osteonecrosis (avascular necrosis): This condition involves the death of bone tissue due to a lack of blood supply and can cause severe pain and soreness, particularly at rest. It is crucial to diagnose and treat early to prevent further bone collapse.
- Bone tumors: Both benign and malignant tumors can cause knee pain and soreness. Although rare, missing a diagnosis of a bone tumor could have significant consequences.
- Rare diagnoses
- Pigmented villonodular synovitis (PVNS): A rare condition characterized by the overgrowth of the joint lining, leading to inflammation and pain. It can cause chronic soreness and is often diagnosed after other conditions have been ruled out.
- Synovial chondromatosis: A rare condition where cartilage grows in the synovium, the lining of the joint, leading to pain, soreness, and sometimes locking of the joint.
- Hemophilic arthropathy: In individuals with hemophilia, recurrent bleeding into the joints can lead to chronic pain and soreness, particularly at rest, due to the inflammatory response and joint damage.