Do I need an MRI for a clicking knee?

Why the examination comes first

Scans are very sensitive. MRI often shows small meniscus changes, cartilage softening or a plica in knees that have no symptoms at all, especially from middle age. Scanning a painless clicking knee can therefore find things that are not the cause and lead to worry or unnecessary treatment.

A careful history and examination usually tells the surgeon whether the click is harmless or mechanical, and whether a scan will answer a real question.

What the surgeon checks

• When the click started, whether there was an injury, and whether it hurts, swells or catches
• Where the click comes from, felt with a hand on the knee while you bend, squat or walk
• The kneecap's position and tracking, and tenderness around it
• Tenderness along the inner and outer joint lines
• Meniscus tests, which gently load the cartilage to reproduce a painful click
• Ligament stability and the full range of movement

Which scan, and when

• No scan: painless clicking with a normal examination
• X-ray: suspected arthritis, a loose body of bone, or kneecap alignment questions; ideally taken standing
• MRI: suspected meniscus tear, cartilage flap, loose body, ligament injury, or a child's knee that clunks or locks
• Ultrasound: useful for a lump or swelling around the knee, such as a bursa or Baker's cyst, rather than for clicking inside the joint

What to expect at Aman Hospital

At a consultation in Doha, Dr. Gelber takes the history, examines both knees and explains what he thinks the click is. If a scan is needed, he explains what it is looking for and reviews the images with you. If you already have an MRI from another clinic, bring the images and report, since this can save repeating it. For cost and insurance coverage, check with Aman Hospital and your insurer before the scan.