Investigations
1st investigations to order
clinical diagnosis
Test
Characteristic history and examination findings are often sufficient to diagnose the condition. A standard knee examination should be undertaken, with particular special (provocative) tests used to support diagnosis. These include the Noble's, Ober's, and modified Thomas's tests.[30][31]
Result
sharp or burning pain and tenderness roughly 2 cm superior to the lateral joint line. Pain may radiate proximally or distally. May also be local oedema and crepitation. Noble's, Ober's, and modified Thomas's tests positive.
Investigations to consider
x-ray of knee
Test
Consider where there is diagnostic uncertainty. The American College of Radiology advises that radiography of the knee is usually appropriate as initial imaging for patients with chronic knee pain.[32]
Result
may be normal or show signs suggestive of other knee pathologies (e.g, joint effusion, osteochondral injuries [fracture/osteochondritis dissecans or a loose body], avascular necrosis, or internal derangement [Segond fracture, deep lateral femoral notch sign])
ultrasound of knee
Test
Consider where there is diagnostic uncertainty.[29]
Result
soft tissue swelling, fluid collection between the iliotibial band and lateral femoral epicondyle
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