Knee Osteoarthritis: Looking Beyond the Common Pain Generators. A Case Report and Review of Literature

Knee Osteoarthritis: Looking Beyond the Common Pain Generators. A Case Report and Review of Literature

Knee osteoarthritis (OA) has a global joint involvement where cartilage, ligament, menisci, and synovium are affected. However, few case studies have reported the involvement of the fibular nerve as the possible pain generator in knee OA. We report a case of a 62-year-old female who has had chronic right knee OA with acute pain exacerbation of 4 months duration. Ultrasound of the right knee showed the following results: knee OA, medical meniscal protrusion, suprapatellar effusion, and fibular neuropathy. Aspiration of synovial fluid from the suprapatellar area and hydrodissection or perineural deep injection of the fibular nerve were performed, resulting in significant pain reduction. Fibular neuropathy should be considered a pain generator in knee OA, especially that pain is felt at the lateral aspect of the knee.