The knee crunches and clicks: what to do?
Crunching and clicking in the knee joints are most often troublesome in older people. However, sometimes young patients also present similar complaints. In the latter case, they are most often associated with heavy physical exertion or prolonged training.
Doctors call a crunch in a joint crepitus. This sound can occur in the knee due to the bursting of air bubbles that form in the synovial fluid during walking. Most often, such crepitations occur due to a person leading a sedentary lifestyle. However, this condition cannot be called pathological.
Crunching, which is a symptom of the disease, occurs due to the fact that the bone structures of the joint rub against each other. It can occur as a monosymptom, or it can be combined with other manifestations of the pathological process, for example, with edema and pain.
Injuries can lead to a crunch in the knee, as well as the presence of excess weight in a person. Under its pressure, the structural components of the joints are destroyed, which leads to the appearance of the corresponding sounds. Sometimes knees crunch due to improperly fitted shoes.
- What can crunch your knee?
- Causes of crunching knee joints
- What can be a crunch in the knee?
- Joint crunch diagnostics
- Knee Crunch Treatment
- Surgical treatment for a crunch in the knee
- Which doctor treats joint crunch?
What can crunch your knee?
A crunch in the knee joint can create its hard structures, including:
- The terminal section of the femur.
- Proximal tibia.
- Menisci and patella.
- Articular cartilage and capsules.
Moreover, both one and several knee elements can crunch.
Sometimes lesions of the soft structures of the knee lead to extraneous sounds, in this case they are explained by a violation of the equivalence between the hard articular surfaces.
Causes of crunching knee joints
There are the following reasons that can lead to crunching in the knee joints:
Gonarthrosis. This disease is accompanied by degenerative changes in the tissues of the joint, as they cease to receive normal nutrition. As a result of such a violation, the cartilage is destroyed, and the joint itself is deformed. The disease often leads to the fact that people are disabled. More often, pathology develops in women. Primary gonarthrosis develops due to hormonal, metabolic or genetic disorders in the body. The secondary form of the disease can manifest itself after an injury or surgery on the lower extremities. In addition to a crunch in the knee joint, a person will experience pain. As the pathology progresses, it increases, and the mobility of the joint is increasingly limited.
- Injury to the menisci: Menisci are most often injured when an external force is applied to them, such as when the knee is suddenly extended, when making sharp turns or jumping from a height. In addition to crunching in the knees, a person has pain, he cannot sit down or even walk normally. During movement, the joint begins to click. In the cavity of the knee joint, synovial fluid can accumulate, which is released in response to inflammation of the synovial membranes of the joint.
Rheumatoid arthritis. This pathology is of an autoimmune nature, most often affects women. Sometimes only one joint suffers, and sometimes several at once. The reasons for the development of the disease have not yet been established. Injuries, hypothermia, viral infections, etc. are considered provoking factors. In addition to a crunch in the knee, a person will experience pain, which increases during movement and touching the affected area. In the morning, the joints feel stiff, and the knees are swollen. The periarticular tissues themselves swell, and fluid can accumulate in its cavity. Crunching occurs during movement.
Gouty arthritis of the knee. This disease develops due to the fact that the metabolism of uric acid is disrupted in the body. Its salts begin to be deposited in tissues and joints, which causes corresponding sounds in them. The knee is rarely attacked by gouty arthritis, but it does happen. More often men of mature age suffer. In addition to crepitations, the patient complains of pain and limited mobility. The knee swells, and the skin over it may turn red and hot to the touch.
Hypermobility Syndrome. With this pathology, the knee joint is characterized by increased flexibility and mobility. The disease develops due to genetic abnormalities, but sometimes it can be acquired as a result of injury, hormonal disruptions, or neurological disorders. The main manifestation of the syndrome is precisely the crunch, which can be accompanied by pain.
Disturbance in the body of calcium and phosphorus metabolism. These microelements form bone tissue, if they are not enough, then this will certainly affect its condition. In addition to crunching, a person will complain of limited mobility in the joint, pain that can begin to pursue even at rest. If you do not get rid of the problem, then the joint will be deformed.
Overweight. With obesity, serious stress is placed on the knee joint. This leads to the fact that it gradually collapses. If you get rid of extra pounds in time, then the pathological process can be stopped. The higher the degree of obesity, the more severe the damage to the structures of the knee.
Chondromatosis of the joint. With chondromatosis, metaplasia of the cartilage of the joint is observed. As a result of this process, chondromic bodies are formed that block the normal mobility of the knee. Most often both legs are affected. In addition to a crunch in the knee, a person will experience painful sensations. The joint swells, which negatively affects the patient's range of motion.
Bursitis. With bursitis, inflammation of the synovial bags occurs. The main cause of the disease are injuries to the joint and excessive physical exertion on it. Sometimes pathogenic flora leads to inflammation of the synovial bags. Symptoms of bursitis include a crunch in the knee, soft tissue swelling, limited joint mobility, and pain.
Dissecans osteochondritis or Koenig's disease. With this pathology, delamination of the cartilaginous plate is observed, which overlaps the bone. With osteochondritis, it is the knee joint that most often suffers. The disease debuts in people aged 20-40 years. Its development can be provoked by injuries, impaired blood supply, excessive stress on the joint. Pathology is always accompanied by painful sensations and crunching. In severe cases, there is a complete blockage of the joint.
Joint osteophytes are growths of bone tissue, which normally should not be present. They are bone growths. The reason for their formation is repetitive stress on the joint, metabolic disorders in the body, as well as osteoarthritis. With large osteophytes, the joint will crunch during movement, stop functioning normally, and begin to hurt.
Dislocation or fracture. Any trauma to bone structures is accompanied by a characteristic crunch. Sometimes the joint can crackle even after the damaged tissue has healed. This is observed in the case of the attachment of a pathological process, for example, with the growth of osteophytes or with bursitis.
Damage to the tendons and ligaments of the knee joint. Damage to the tendons and ligaments leads to the fact that the structures of the knee joint lose stability, their anatomy is disrupted, which leads to the occurrence of crunching.
Chondromalacia of the patella. With this disease, the destruction of the cartilage tissue of the joint occurs. It becomes thin, cracks appear on it. As the pathology progresses, the patella and femur condyles will suffer. Earlier knee injuries and excessive loads on it can provoke chondromalacia. Crunching and pain will occur during joint movement.
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What can be a crunch in the knee?
Most often, a crunch in the knee joint occurs during flexion and extension. It is the crunch that is the first symptom of damage to the structures of the knee. It can indicate deformation of the cartilage tissue, damage to the ligaments, joint capsule, cartilage or muscles. Although sometimes joints can crackle simply due to the fact that a person leads a sedentary lifestyle.
During squats, the joints often crunch in athletes. This should not normally happen. Therefore, if a person is actively involved in sports and notices a pathological crunch in himself, he needs to consult a doctor. It may be necessary to give up heavy physical exercise, in which the load falls on the lower limbs.
A crunching knee is almost always painful. The more intense the pain, the more severe the degree of the pathological process. You can't stand pain. It is necessary to contact a specialist and find out the reasons for its occurrence.
Joint crunch diagnostics
During the appointment, the doctor will listen to the patient's main complaints and examine him.
To clarify the diagnosis, the following studies can be assigned:
- General and biochemical blood test.
- General urine analysis.
- Ultrasound of the knee joint.
- X-ray examination of the knee joint.
- Collection of synovial fluid and its analysis.
- Arthroscopy. This method can be performed not only for diagnostic but also for therapeutic purposes. The procedure is performed under anesthesia. During its implementation, an arthroscope is inserted into the joint and the internal structures of the knee joint are examined on the monitor.
- CT or MRI of the joint.
Knee Crunch Treatment
To get rid of the crunch in the knee joint, it is necessary to identify the pathology that led to the development of this symptom. In case of injury, the limb is immobilized by applying special splints or a plaster cast to the leg.
Depending on the cause of the knee crunch, the following medications may be prescribed:
- Preparations from the NSAID group. They reduce inflammation and pain, relieve swelling. They are taken orally and applied to the sore joint. These can be drugs such as Ibuprofen, Diclofenac, etc.
- Corticosteroids. These drugs are prescribed to relieve inflammation. Injections are injected into the joint cavity. These drugs include Prednisolone, Hydrocortisone, Triamcinolone.
- Drugs for the treatment of gout: Colchicine and Allopurinol. They prevent excess production of uric acid in the body, accelerate its excretion and eliminate disease symptoms. Medicines are taken orally.
- Basic anti-inflammatory drugs are aimed at stopping the destruction of cartilage and bone tissue of the knee joint. As intramuscular injections, drugs such as Azathioprine, Cyclosporine, Methotrexate are used.
- To strengthen bone tissue and to restore bone strength, vitamin and mineral complexes are prescribed.
- To improve the condition of the cartilage tissue and stop the process of its destruction, patients are prescribed chondroprotectors. These can be drugs such as: Glucosamine, Chondroitin sulfate and Hyaluronic acid. The drugs are taken orally, or they are injected with them.
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Diet. If a patient is diagnosed with obesity or gout, then diet becomes the main focus of treatment.
With gout, limit the consumption of foods that can lead to the accumulation of uric acid salts in the tissues. Exclude meat dishes, fish, broccoli, cauliflower, dates.
For obesity, the menu should be drawn up by a nutritionist. In addition, a person needs to change his lifestyle, increase physical activity.
To normalize phosphorus-calcium metabolism, it is required to enrich the diet with cottage cheese, fish, milk and fermented milk drinks.
Surgical treatment for a crunch in the knee
If the conservative way failed to cope with the existing problem, then the patient is indicated for an operation.
Depending on the cause of the disorder, the following treatments can be used:
Joint arthrotomy. In this case, the diseased joint is opened and the inflammatory exudate is pumped out of it. If necessary, then remove foreign bodies. This is a gentle operation that injures the structures of the joint to a small extent.
Tenorraphy. This procedure aims to suture the tendons if they are torn or otherwise damaged. In this case, the person will be immobilized for 1-1.5 months.
Arthroplasty. The operation is performed with joint contractures, which led to a change in its shape, or to a pronounced dysfunction of the knee. It is possible to replace the damaged joint with a prosthesis.
Puncture of the knee joint. During the puncture, drugs are injected into the articular cavity, and the inflammatory exudate is pumped out. Thus, it is possible to reduce the pressure inside the knee and reduce the intensity of pain.
Synovectomy. This procedure aims to remove the synovium of the joint. It is indicated for rheumatoid arthritis, provided that the inflammation cannot be stopped with the help of drugs. The joint's own sheath is replaced with a synthetic sheath. The operation is resorted to only in extreme cases.
Synovcapsulectomy. This operation involves removing not only the synovial membrane, but also the capsule of the joint itself. It is practiced for advanced arthritis, when the structures of the knee joint are severely damaged.
Arthroscopy is performed using endoscopic equipment. Local or general anesthesia is possible, depending on the extent of the surgical intervention. It is prescribed to patients with pathologies of the menisci or ligaments, with osteoarthritis. The procedure is minimally invasive and quick enough.
Osteosynthesis. This procedure is indicated for patients with fractures. During its implementation, the integrity of the joint is restored by comparing the bone fragments. After the operation, the knee joint is fixed and immobilized until the bones are completely healed.
Meniscectomy. The operation involves removing the knee menisci. Access to its structures can be open and closed. In the latter case, endoscopic equipment is used.
Elimination of damage to the ligamentous apparatus. The operation is indicated for patients who have a ruptured knee ligament. In the course of its implementation, the ligaments are sutured. Immobilization of the limb after the procedure continues for 1-1.5 months.
After the main stage of treatment is completed, the patient will need to maintain the health of the knee joint. To do this, he is selected for physical therapy complexes, physiotherapeutic treatment is prescribed (massage, electrophoresis, paraffin therapy, etc.).
It is good to go in for swimming, since in the water the joint does not receive loads that could injure it again.
Which doctor treats joint crunch?
If a person's joint crunches, then the help of an orthopedist, traumatologist or rheumatologist may be required. It all depends on what kind of pathology triggered the onset of this symptom. If you cannot get an appointment with these specialists, then first you need to visit a therapist.
Author of the article: Kaplan Alexander Sergeevich | Orthopedist
Education: diploma in the specialty "General Medicine" received in 2009 at the Medical Academy. I. M. Sechenov. In 2012 completed postgraduate studies in Traumatology and Orthopedics at the City Clinical Hospital named after Botkin at the Department of Traumatology, Orthopedics and Disaster Surgery.