KNEE PAIN DIAGRAMS - CORRELATION WITH PHYSICAL-EXAMINATION FINDINGS IN PATIENTS WITH ANTERIOR KNEE PAIN

All new patients who presented with knee problems were asked to fill o ut standard knee pain diagrams before being evaluated. Completed diagr ams were not seen by the examining physicians. After obtaining the his tory and performing the physical examination, one of four physicians m arked an identical diagram with the areas of tenderness. Ninety patien ts with a provisional diagnosis of patellofemoral pain completed 109 ( 19 bilateral) pain diagrams. Evaluation of the diagrams was quantitate d by division of the diagrams into nine zones. The researcher grading the diagrams was blind to whether the diagrams were drawn by the patie nt or physician. Patients marked an average of 4.23 zones per knee com pared with 2.66 zones for physicians. In 88% (96 of 109) of the knees, the physician diagram included ah or some of the zones marked by the patients. Eighty-five percent of all zones marked by physicians were i ncluded in patient diagrams. Eighty-six percent of negative patient zo nes correctly predicted a negative examination. Overall frequency of p ositive findings in each of the nine zones was consistent between pati ent and physician diagrams. A physician can be confident that findings of tenderness will likely be within zones marked by a patient on a st andard diagram of the knee. Pain diagrams facilitate proper diagnosis by correctly directing attention to areas of tenderness in a large per centage of cases and provide an inexpensive and highly useful predicti on of areas of anterior knee tenderness in patients with patellofemora l pain.