Twisted knee with clicking: possible meniscus lesion to be ruled out

Patient

Q: I twisted my knee yesterday. It is swollen and hurts but I can still bend it. When I walk there is a clicking noise not all the time but most. Is that normal?

Doctor

A:    The menisci are C-shaped wedges of fibro cartilage located between the tibia and femur, and very close related to knee ligaments and attached also to the joint capsule. They are susceptible to get injured with leg rotation movements or rotational forces applied to them, and the lesion produced can be partial or complete tear. Meniscus injuries are common in young and active people as you, who are involved in sporting or physical activities. In your particular case would be important to rule out a possible Meniscus lesion if you are experiencing, besides the click, also locking or buckling. The Locking usually occurs at 20-45° of joint extension. Joint inflammation or capsular involvement also may resemble locking. A more reliable indicator of meniscus lesion is a click or snaps after the joint unlocks, it can be or not associated with pain. A sensation of giving way may occur when the loose fragment becomes lodged for a moment in the knee joint, causing a sense of buckling. Spontaneous healing is common because of the rich blood supply in the meniscal periphery. Successful recovery from a meniscal tear is helped by a gradual resolution of symptoms over 6 weeks with a return to normal activity by 3 months. Many meniscal tears heal spontaneously. Also, can be treated with casting depending of the severity of the tear. With time the symptoms improve. If there is no significative improvement you should get a clinical (orthopedic surgeon) and Imaging (MRI) evaluation of your knee.
 

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