The synovial membrane lines the knee joint and secretes synovia into the joint cavity. This membrane, like other tissues of the body, can become irritated and inflamed, resulting in chronic inflammation or a chronic infection, depending on the cause. Torn cartilage, joint mice (see section on loose bone or cartilage below), chondromalacia, overuse, and other causes account for these changes.
Below are knee ailments characterized by pain throughout the knee system. Bursitis, the first condition reviewed here and commonly called "housemaid′s knee," affects many people whose daily work keeps them on their knees–housekeepers, carpet layers, and electricians, for example.
Below are described common knee and related problems by the area where the pain is felt: the knee in general, the kneecap in particular, the sides of the knee, and the front and back of the knee. Some of these are more common to children, adolescents, or young adults (avulsion fractures, bone and cartilage separation, growth plate inflammation, patellar-femoral syndrome) or older adults (localized arthritic condition) than to others.
The children′s rhyme gets us started in the right direction. The knee is connected to the thighbone, but it may not be quite as simple as you think. Flexing or extending your knee moves three other bones besides the kneecap; the femur, or leg above the knee, connects to the tibia (shin) and the fibula (nonweight-bearing bone) of the leg below the knee.
It depends on an intricate system of interior and exterior bands, special surfaces, and natural shock absorbers to facilitate and smooth the action, to say nothing of keeping the lower leg attached to its upper counterpart. That the knee is more than mechanical parts is best demonstrated by the fact that medical device manufacturers have not been able to devise an artificial replacement that truly reproduces the knee’s capabilities.
First impressions are generally right. In medicine, evaluations of this sort are sometimes called intuitive diagnoses. When I am examining a patient at my office and I put my hand on the patient′s knee, I can usually sense the emotional state of the patient, and that gives me information I need to understand this patient′s unique case. In this exchange, I am reminded of the significance of touch not only in healing but also in transferring something spiritual.