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Médecin en blouse bleue et gants médicaux, main tendue tenant un graphique flottant d'un scan du genou entouré d'icônes médicales flottantes sur un fond bleu pâle.

Douleur au genou persistante : Quand faut-il passer une IRM ?

Knee pain is very common, but it isn’t always easy to pinpoint what’s causing your symptoms. Pain in the knee can start as a low-grade ache that gradually gets worse, or suddenly after an injury and doesn’t go away.

Many people live with persistent knee pain for months or years, taking painkillers or resting their leg when necessary. But long-term knee pain can interfere with your quality of life and ability to work, and affect your participation and enjoyment in sports and leisure activities.

Persistent knee pain, or pain that doesn’t improve, may require further investigation. Having a scan will provide clarity on what’s causing your symptoms and what treatment options might be available to you. But it’s sometimes difficult to know when to get a scan and which type to choose. Scan.com helps make it more straightforward.

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Why does knee pain linger?

Sometimes, knee pain is caused by age-related wear and tear that degrades the cartilage. Cartilage is a type of soft tissue that cushions the spaces between the bones within a joint, such as the knee. If it wears away, the bones can rub against each other, causing pain and inflammation that worsen over time.

Knee pain can also be caused by soft-tissue damage such as tears in tendons or ligaments, resulting from injury, overuse, or repetitive strain. Sometimes, these injuries don’t heal on their own and can lead to long-term knee pain and instability. If you have a knee injury and it isn’t diagnosed or treated, your pain may repeatedly come and go.

The knee is a complex joint made up of bones, muscles, tendons, ligaments, and cartilage, and if it becomes injured or you repeatedly lift heavy objects, twist at the knee, run or otherwise put pressure on this joint, you may experience knee pain that doesn’t get better.

Common causes of ongoing knee pain

There are numerous conditions that can affect the knee joint, causing pain and other symptoms.

  • Ligament injuries - sprains to the anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL) often caused by twisting the knee during exercise, which can cause an immediate popping sound on injury, and instant pain, swelling and instability.

  • Muscle and tendon injuries - strains to the muscles and tendons in the knee that can cause cramps, spasms and weakness.

  • Meniscus tears - tears or damage to the cartilage in the knee joint, often caused by twisting the knee during sport, that can cause pain and a locking or catching sensation in the knee.

  • Cartilage damage - inflammation can also cause cartilage damage, leading to the onset of rheumatoid arthritis.

  • Early osteoarthritis - caused by wear-and-tear in the knee joint as the cartilage wears away, leading to stiffness, swelling and pain that gradually feels worse.

  • Dislocations and fractures - damage to the knee bone, most commonly the kneecap, caused by a fall or a direct blow to the knee, leading to immediate pain, swelling, bruising and difficulty walking.

When should you consider imaging?

Knee pain might feel normal to you if you’ve been experiencing discomfort for some time. But you should consider a knee scan if:

  • You’ve had pain and discomfort in your knee for more than 6 to 12 weeks that hasn’t improved despite trying painkillers, rest, or physiotherapy.

  • You’re experiencing knee swelling that comes and goes.

  • Your knee locks, or you can feel a catching sensation when you walk or move your knee.

  • Your knee feels unstable, or it gives way when you put weight on it.

  • You’re experiencing persistent pain that’s affecting your ability to work, sleep or participate in sports or leisure activities.

  • You have knee pain and aren’t sure what’s causing it.

Having a knee scan is also recommended if you experience sudden knee pain, your knee looks out of place after an injury or accident, or if you feel a sudden ping or pop in the knee.

X-ray vs MRI vs ultrasound: What’s the difference?

X-rays, MRIs, and ultrasounds are all types of medical scans used to create detailed images of the inside of the knee. They show different tissues and structures and work in different ways.

Knee MRI

MRI scans use radio waves and a strong magnetic field to create images of the bones and soft tissues. They’re capable of producing highly detailed images of the internal joint structures and can highlight damage to the ligaments, cartilage, and meniscus and bruising to the bones.

They’re safe for most people, radiation-free, and are often recommended for knee imaging.

Knee X-ray

les radiographies use low-dose radiation to show the bones in detail and are therefore useful for diagnosing bone fractures. They can also reveal significant joint spaces where cartilage has worn away, leading to moderate to advanced osteoarthritis.

They’re not so good at revealing early-stage osteoarthritis and can’t clearly show damage or injury to the soft tissues, such as the ligaments or cartilage.

Knee ultrasound

Ultrasounds use high-frequency sound waves to produce a dynamic, real-time image of the inside of the knee joint. They can even be used to look at the mechanics of your knee joint while you’re moving.

They’re best for assessing soft tissues and diagnosing problems such as fluid build-up, bursitis and tendonitis. They’re not good for creating images of the tissues deep within the joint structure.

What an MRI can reveal that an X-ray can’t

While an X-ray is useful for detecting bone fractures and late-stage osteoarthritis, an MRI can help doctors diagnose a wider range of conditions that can cause knee pain.

MRI scans can diagnose early cartilage damage, meniscus tears, and ACL and PCL injuries. They can also reveal early-stage inflammation and subtle stress fractures that might not be detected on an X-ray.

Do you always need a scan?

Having a knee scan to diagnose the cause of pain and instability can be a recommended first step if you’ve experienced a significant injury or you’re playing sports at a semi-professional or professional level.

In many cases, knee pain can be managed with antalgiques and rest, while other types can be treated with physiotherapy and exercices de renforcement.

But if you have knee pain that isn’t getting better, a scan is still a good idea. Scan images will provide you and your doctor with clarity over what’s causing your pain, allowing you to make informed decisions about your treatment.

Getting answers without the wait

Knee scans do involve waiting lists if you get one via the NHS. But, private providers like Scan.com can be accessed immediately with no GP referral required.

You’ll have your results in days, and your scan includes a consultation with an expert radiologist and a digital report that you can share with your NHS GP or specialist. Each booking is reviewed to ensure you’ve booked the most appropriate scan for your symptoms.

What happens after a scan?

Having a knee scan will give your doctors a clear idea of what’s going on inside your knee joint to cause your pain. Knee scans provide insight into the specific issue or injury and its extent.

Once you have your scan results, you can decide whether to continue your care with one of Scan.com’s clinical experts or seek treatment with another private consultant or the NHS.

Either way, your doctor can confidently make a diagnosis, and together, you can explore a tailored treatment plan. This might involve a combination of rest, physiotherapy and knee and leg strengthening exercises, or it might mean surgery for more serious knee injuries, such as an ACL or PCL tear or a bone fracture.

You and your doctors can also make treatment decisions based on your age, fitness level and occupation.

Gain clarity from a knee scan

Having persistent knee pain may be stopping you from exercising, playing sports and taking part in the leisure activities you enjoy. But it doesn’t have to be that way. A scan will give you the clarity you need to make treatment decisions and move forward.

Questions fréquemment posées

Qu'est-ce que le cartilage et pourquoi est-il important pour mon genou ?

Le cartilage est un type de tissu mou qui agit comme un coussin entre les os de votre articulation du genou. Il est important car il aide à empêcher vos os de frotter directement les uns contre les autres, ce qui provoquerait douleur et inflammation.

La douleur au genou peut-elle disparaître d'elle-même, ou nécessite-t-elle toujours un traitement ?

Parfois, la douleur au genou, en particulier due à des lésions des tissus mous, peut ne pas guérir d'elle-même et entraîner une douleur et une instabilité à long terme. Si une blessure n'est pas diagnostiquée ou traitée, votre douleur peut revenir de manière récurrente. Un diagnostic et un traitement rapides peuvent prévenir cela.

Comment puis-je savoir si la douleur à mon genou est suffisamment grave pour justifier un examen ?

Vous devriez envisager une IRM du genou si vous ressentez des douleurs et un inconfort depuis plus de 6 à 12 semaines qui n'ont pas été soulagés par des analgésiques, du repos ou de la physiothérapie. D'autres indicateurs incluent un gonflement du genou qui va et vient, une sensation de blocage ou de coincement, une instabilité ou un genou qui lâche, une douleur persistante affectant les activités quotidiennes, ou si vous n'êtes pas sûr de la cause de votre douleur au genou.

À quoi puis-je m'attendre dans un plan de traitement personnalisé après un scanner du genou ?

Après un examen, votre plan de traitement personnalisé pourrait inclure du repos, de la physiothérapie et des exercices de renforcement pour votre genou et votre jambe. Pour des blessures plus graves comme une déchirure du LCA ou du LCP ou une fracture osseuse, la chirurgie pourrait être une option. Votre âge, votre niveau de forme physique et votre profession seront également pris en compte lors de la décision du traitement.

Quelles conditions spécifiques une IRM peut-elle identifier dans le genou ?

Une IRM peut révéler des dommages précoces au cartilage, des déchirures du ménisque et des blessures au ligament croisé antérieur (LCA) et au ligament croisé postérieur (LCP). Elle peut également détecter une inflammation à un stade précoce et des fractures de stress subtiles qui pourraient être manquées par une radiographie.

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Scan.com

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Dr Colin Tidy, MRCGP

Médecin généraliste, Auteur médical

MBBS, MRCGP, MRCP (Paediatrics), DCH

Le Dr Colin Tidy est un médecin du NHS, basé dans l'Oxfordshire.

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Les informations sur cette page sont examinées par des cliniciens qualifiés.

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