What’s causing my swollen knee?

Symptoms:

You were playing tennis and twisted your knee. Within minutes your knee swelled up, it feels tense and very sore. You can’t stand for the severe pain. You’re in your 60s and for some time now your knee has been making a grating sound when you bend it, it’s becoming more and more swollen and painful.

You’ve got a soft swelling on the front of the knee, you’re a keen gardener and have been kneeling a lot, weeding and planting.

It could be:

A torn ligament. This is the most common cause of rapid swelling of the knee and usually involves the ACL (anterior cruciate ligament). Osteoarthritis due to the wear and tear of the cartilage at the end of the knee bone causing the joint to produce extra fluid. Prepatellar bursitis, aka housemaid’s knee, due to excessive friction when you kneel a lot. The bursa is small fluid-filled sac that lies between the bones and soft tissues and is there to reduce friction.

Stop it:

Go to A&E for a scan to check for a fracture. Fluid may be taken off your knee for examination. Your knee may be bandaged and you’ll need physiotherapy. See your doctor for a diagnosis, lose weight if you can, use a stick to get about, take NSAIDS for the pain, eventually you may need a knee replacement.

See your doctor to confirm the diagnosis, who may have the facilities to remove the fluid from the sac or refer you to a surgeon for treatment. Don’t kneel for a while.