Pain under the kneecap at the front: possible causes

Pain under the kneecap at the front is a common complaint in people of any age. The knee is built like a lever: the patella works together with the quadriceps tendon and the patellar ligament, and cartilage and menisci lie between the bones. When any of these structures is damaged or altered by disease, pain and difficulty walking appear.

What the front of the knee consists of and where pain can occur

The knee joint connects the femur and tibia and the patella. At the front, the patella is connected to the quadriceps muscle of the thigh by a tendon, whose continuation is the patellar ligament. The ligamentous apparatus includes the collateral and posterior ligaments, and inside the joint are the cruciate ligaments and menisci — crescent-shaped cartilages between the articulating surfaces. There are also synovial bursae, including the infrapatellar and prepatellar bursae. Pain can occur under the kneecap, above it, to the side, or around it — depending on which structure is involved.

Why pain occurs under the kneecap: main causes

Pain between the kneecap and the shin that arises from repeated running or jumping is characteristic of tendinitis. In adolescents and young people, pain and swelling below the patella may be a manifestation of Osgood-Schlatter disease. Among the causes of pain without obvious trauma are osteoarthritis (pain and stiffness in both knees, mild swelling, more often in older people), bursitis (the knee is warm and red, worse when kneeling and bending), gout or septic arthritis (sudden attacks of very severe pain, a hot and red knee), and bleeding into the joint.

Knee pain when walking, bending, and after running

After a strain, overuse, or twisting during sports, the issue is usually sprains and overexertion. If the knee is unstable, gives way when trying to stand up, does not straighten, and there was a pop at the moment of injury — a rupture of a ligament, tendon, or meniscus or cartilage damage is possible. Displacement of the kneecap after a blow or a sudden change of direction indicates its dislocation. Sources list such signs: pain after overuse, twisting, knee instability, inability to straighten it.

How pain in the front of the knee is diagnosed

The doctor asks about trauma and physical loads, examines the knee, and checks movements. In cruciate ligament ruptures, the doctor assesses the drawer sign. To clarify the diagnosis, X-ray, computed tomography, or magnetic resonance imaging are used, and sometimes arthroscopy — examination of the joint from the inside with a probe. The doctor may then refer the patient to physical therapy, to a specialist, or for surgery.

When knee pain requires a visit to the doctor

You should see a doctor if the pain does not resolve within a few weeks. Urgent assessment is needed when the knee is very painful, does not move, it is impossible to bear weight on the leg, it is severely swollen or has changed shape, it locks, gives way, or clicks painfully (a painless click is normal), and also with a high fever together with redness and heat around the knee — a sign of infection.

• pain between the kneecap and the shin after running or jumping — tendinitis
• pain and swelling below the patella in adolescents — Osgood-Schlatter disease
• stiffness in both knees in older people — osteoarthritis
• a warm red knee when kneeling — bursitis
• sudden very severe pain in a hot knee — gout or septic arthritis

On its own it is not a reason to call an ambulance; 103/112 — if after a severe injury the knee has clearly changed shape, and also with a high fever with chills, redness, and heat around the knee (infection is possible).

The material is for reference: it helps to understand possible causes but does not replace a doctor's consultation.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer