Continuing Medical Education (CME)

Knee Pain: Acute and Chronic Knee Pain
in Adults and Children

Introduction to this self-study CME activity

Purpose

Knee pain is a common presenting complaint in primary care. This self-study activity provides practical guidance to clinicians about (1) a comprehensive, yet efficient evaluation of knee pain, (2) appropriate use of knee x-rays and MRI, (3) optimal treatment of knee pain, and (4) indications for consultation. Key points include:

• The majority of atramatic knee pain is caused by patellofemoral syndrome and osteoarthritis, which respond to knee strengthening exercises and symptomatic care.
• Plain x-ray and MRI are usually not useful for the evaluation of atraumatic knee pain unless certain specific history and physical examination features are present.
• Majority of knee pain responds to ice, analgesics, NSAIDS, leg flexibility and strengthening exercises.
• Initial drugs of choice for knee osteoarthritis are acetaminophen and/or topical capsaicn. If a traditional NSAID is indicated, the choice should be based on cost. COX-2 inhibitors are no more effective than traditional NSAID agents and should be reserved for carefully selected patients.
• A home treatment program should be explained in detail to the patient.
• Initially, formal physical therapy is not usually required.

Audience

This self-study activity is appropriate for primary care clinicians and other health care providers who diagnosis and treat knee pain in children and adults.

Authors

Team Leader
	Robert Kiningham, MD Family Medicine
Team Members
	Jeffrey Desmond, MD Emergency Medicine David Fox, MD Adult Rheumatology Hilary Haftel, MD Pediatric Rheumatology Mark McQuillan, MD General Medicine Adult Rheumatology Edward Wojtys, MD Orthopedic Surgery
Author Disclosures
	Team Member Company Relationship Robert Kiningham, MD (None) Jeffrey Desmond, MD Pfizer Consultant David Fox, MD (None) Hilary Haftel, MD (None) Mark McQuillan, MD (None) Edward Wojtys, MD (None)

Other Acknowledgements

UMHS Guidelines Oversight Team: William E. Chavey, MD R. Van Harrison, PhD Connie J. Standiford, MD Literature search services: Taubman Medical Library Production of Internet format and web site maintenance: Ellen Patrick-Dunlavey, MA

CME Accreditation and Credit Designation

The University of Michigan Medical School is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The University of Michigan Medical School designates this educational activity for a maximum of 1 AMA/PRA Category 1 Credits™.  Physicians should only claim credit commensurate with the extent of their participation in the activity.

This CME activity was released in November 2002, with credit available through June 2005. The activity was reviewed for currency of content in July 2005 and availability of credit extended through June 2008. This activity was again reviewed for currency of content in June 2008 with credit extended through June 2010.

Method of Participation

1. View the web pages. You may print the self-study text to read off-line.
2. Complete the on-line learning assessment test.  It will be electronically scored and the correct answers returned immediately for your review.
3. Complete the electronic credit request and activity evaluation.  An electronic certificate of participation will be provided immediately.
4. Print the certificate of participation for your personal records.

 

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