How to diagnose isolated articular cartilage lesions of the knee in a consulting room

In order to clinically diagnose articular cartilage lesions of the knee in a medical examination, 121 knees (117 cases) with isolated lesions were investigated. Lesions of the patella (PAT), facies patellaris (F-PAT), lateral femoral condyle (LFC), lateral tibial plateau (LTP), medial femoral condyle (MFC), and medial tibial plateau (MTP) were found in 15, 10, 9, 57, 24, and 6 knees, respectively. The lesions often occurred in athletes, but many cases with lesions did not have a history of trauma. Giving way, pain in maximal flexion, pain after exercise, and pseudolocking were relatively common symptoms. Atrophy of the thigh on the involved side was not severe. Mild limitations in both extension and flexion were often found. Hydrarthrosis was frequent in cases with F-PAT, LFC, and MFC lesions. Valgus alignment was found in LTP lesions, while varus alignment was found in MFC and MTP lesions. Findings of fibrillation in PAT, flaps, deep defects, and softening in F-PAT and MFC, deep defects in LFC, and softening and fissuring in LTP were often seen during arthroscopy. Cartilage lesions such as softening were also thought to be related to the symptoms. Increases in joint fluid may suggest lesions in F-PAT, LFC or MFC where deep and wide lesions often occur. Cases with valgus alignment may have LTP lesions and those with varus alignment may have MFC or MTP lesions.