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KNEE ANATOMY
As illustrated in this diagram, the knee joint consists of three bones, the ends of which are covered with a special, slippery type of articular cartilage. Between the weight bearing bones, the femur and tibia, are two cushions called menisci (sing.: meniscus) that are crescent-shaped, weightbearing structures. Holding the femur and tibia together are a system of ligaments, the most critical of which are the anterior cruciate ligament (ACL), the posterior cruciate ligament (PCL), the medial collateral ligament (MCL) and the lateral collateral ligament (LCL). The interior of the knee joint which is not covered with cartilage is covered entirely by synovium, a soft tissue that produces synovial fluid to lubricate the knee joint’s motion.
There are other interior knee structures, of course, but for basic understanding, these are the structures most susceptible to injury, disease and degeneration.
Knee pain can be caused by damage, disease or injury to any of these critical anatomic structures. In many cases, the structure responsible for a person’s knee pain is not readily discernable. ACL pain can resemble meniscus pain or synovial pain. A critical, professional examination is necessary to sort out the most likely culprit structure, often followed by imaging tests such as
x-rays, MRI scans, arthrograms that involve injecting an x-ray dye into the joint or even ultrasounds. Which imaging test is most relevant is subject to the examining physician. But a competent physical examination of the knee is most critical in every case of knee pain.