Patient: Two weeks ago I fell off my peddle bike and landed on my knee and face. My face is better but I am worried about my knee. There looks like there may be internal bruising, it’s a faint bruise, and there seems to be a few small lumps in m my knee that were not there before. If I kneel on my knee no matter the surface type, it hurts greatly, and sometimes I black out. It also hurts if it is bumped, but not when standing or sitting. What do you suppose could have happened, and do you recommend I have x-rays taken? Thank you.
Doctor: Direct blows to the knee may produce injury of the ligaments, menisci, bones or capsule, but if there is no significant t swelling or deformity, and no limitation on the active movements (flexion, extension), a fracture or dislocation can be ruled out. Also if there is no instability or locking a menisci lesion may be ruled out. The suggested strategy for the initial treatment includes: use of local ice, rest, elevation of the leg, anti-inflammatory drugs (as “advil”, “motrin”) and the use of a knee immobilizer as needed. If all these directions are followed, then the normal function should return in few days to weeks, the healing time depends on the severity of the initial injury and every patient in particular, but if the pain, swelling and limitation on the movements persist an Orthopedic Surgeon must re-evaluate the injured knee and decide about the right imaging studies to order, in order to determine the right treatment option. Try to do series of contractions of the quad while you have the leg in elevated position, and also flexion-extension of the ankle-foot.