Question
Dr. Gillman,

I am concerned about my knee and would like to present to you my case. I
would very much appreciate any information and advice you could give me.

SYMPTOMS
I have been suffering from discomfort in my left knee for the past two years
(on for 3 months, off for another 3, on again...). The discomfort has never
reached the point where I have had to stop playing sports or change my way
of doing things. I've been able to live with it and haven't had to stop sports
that involve leg movement. It has never hurt, per se. Only discomfort.

I've recently been able to locate two parts of my knee where I can hear
clicking as I move it as described below:
1. While performing a squat standing only on my left leg: I can feel the
clicking on the surface of the skin located on the left side of my knee,
between the femur and the tibia. I can actually feel the click as I place my
hand on the area.

2. While standing on my right leg and with my left thigh raised and fixed at
about 45 degrees. With my thigh fixed I swing my left leg back and forth: I
can feel the clicking on the surface of the skin located on the upper right side
of my knee and to the right of the patella.

The discomfort is located in the areas where I hear and feel the clicking and is
mostly present after I do exercise. I never feel discomfort in the mornings or
during periods of rest unless it is after doing exercise.

At times and during periods of rest I can feel the skin in the aforementioned
areas move/twitch on its own.

HISTORY
I am a 24 year old male and have been playing sports my whole life.
Additionally, I have never been overweight.

Two months after this discomfort started, I went to see a doctor and after
some X-rays he said that it was a tendinitis. He saw no damage in the bones
and no arthritis. The symptoms are the same and I am starting to wonder if it
is something else.

My left leg has always been very elastic and never hurts when I twist it.

QUESTION/CONCERN

What do you suggest? What do you think all of this could be?
My plan is to live with the discomfort as I have done until now unless things
get worse.

Answer
Stan,

This is a common symptom pattern.  You may have what's called a "Plica" syndrome.  Google "Plica" of the knee and read a bit about it.   See if it fits your symptoms pattern.   There are some other tissues that traverse the front and sides of your knee joint, including the "pes anserine bursa" and pericapsular ligaments that can get thickened up or adhered.  They will be a source of pain with such activities as squatting, but often are not bothersome when going up or down stairs.   Graston Technique (www.grastontechnique.com) is the preferred method for dealing with these tissues.  If a knee plica gets really thick and doesn't respond to treatment, then it is best to get it surgically removed.  Look of some of these terms and feel free to correspond with me.  

'Best,

Dr. G