Knee pain triage
Primary care knee pain framework balancing injury-rule use, conservative care, and escalation criteria.
Last reviewed February 7, 2026
Red flags
- Inability to bear weight after trauma with high fracture concern.
- Hot swollen joint with systemic features suggesting septic arthritis.
- Progressive neurovascular symptoms or severe instability.
Assessment priorities
- Clarify injury mechanism, load tolerance, swelling, and instability symptoms.
- Screen for fracture risk and septic-joint warning features.
- Assess impact on mobility and daily function.
Initial management
- Use validated decision rules to guide imaging where appropriate.
- Start symptom-guided conservative management and function plan.
- Document criteria for urgent reassessment.
Follow-up and escalation
- Reassess pain/function trajectory and weight-bearing status.
- Escalate for persistent instability, severe swelling, or infection concern.
- Refer for refractory symptoms or suspected structural injury.
References
- Choosing Wisely Canada recommendations (opens in a new tab)
- Toward Optimized Practice clinical practice guidelines (opens in a new tab)
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