The causes of knee pain are many- consider diagnoses like meniscus tears, ITB syndrome, patellofemoral syndrome, ACL, PCL tears, tendonitis, and you get an idea for what needs to be teased out of that pack.
To properly diagnose a meniscus tear through clinical examination, the pain symptoms and signs must be further qualified- Did the injury occur during a twisting type activity? Is there pain at the joint line? Does the pain occur during knee bending and/or the very end of knee bending? Is there associated knee buckling or a "giving way" sensation? Is there clicking or "catching" sensation? Most likely a meniscus tear may be the culprit.
Is an MRI absolutely necessary in diagnosing a meniscus tear? Usually not. A thorough clinical examination by an orthopedist or physical therapist is usually sufficient. People often wonder, "how do you diagnose a tear without being to see it?" I can attest that a good examination not only quickens access to necessary care, but also is may be more accurate at times than an MRI (seeing isn't always believing, since MRIs can produce a false positive- ask any radiologist!).
Meniscus tears are particularly a problem for athletes since the cutting, pivoting, rapid stop and go movements can cause these tears to occur. Menisci lesions may or may not heal on their own due to the fact that the meniscus (lateral and medial) are particularly avascular (less blood supply to the area). The menisci rely on joint movement and some compression to receive nourishment for repair and general health.
Physical therapy can be effective in treating menisci lesions through specific manual techniques and activities, and many athletes and non-athletes are able to return to their activities unhampered. In cases where symptoms become more constant, surgery is generally recommended and then resumption of physical therapy is needed for proper return to sports and activities of daily living.
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