Every joint in this Journal makes noise at some point. Knees crackle on the way up a flight of stairs, shoulders pop when an arm swings overhead, necks click on the first turn of the morning. Most of those sounds are ordinary, painless, and years old. The reader who writes to the desk after a crash is usually asking about a different sound: the one that was not there last month.
This entry is not going to tell you what a noise means. A webpage cannot hear your knee. What it can do is help you describe the sound well enough that the person who examines you can do something with the description.
Old noise and new noise
The first thing an examiner will want to know is whether the noise is new. That sounds obvious, and it is surprisingly hard to answer honestly, because people start listening to their joints after a crash and hear things they never noticed. A good answer sounds like one of these:
- "My knees have always cracked on stairs. That has not changed."
- "My right shoulder never clicked before the crash. It clicks every time I reach back for the seatbelt now."
- "I am not sure. I never paid attention before, but it hurts when it clicks now, and it did not hurt before."
The third answer is a perfectly good one. Uncertainty stated plainly is more useful than a guess stated confidently.
Five things worth noting about a joint noise
1. Which movement makes it
Be specific. "Going down stairs, not up." "Lifting my arm out to the side past shoulder height." "Turning my head left to back out of the driveway." A noise tied to one movement gives the examiner a movement to test.
2. Whether it hurts
A painless noise and a painful one are different reports. If it hurts, say whether the pain comes before the click, with it, or after it, and whether the click brings any relief.
3. Whether the joint catches or locks
Some readers describe a knee that sticks partway through bending and has to be eased free, or a shoulder that seems to catch on something. Catching and locking are worth saying in those words, because they are not the same report as a sound.
4. Whether it gives way
A knee that buckles on a turn, or an ankle that rolls on flat ground, is a separate and important report. Note when it happened and what you were doing.
5. Whether swelling comes with it
A joint that clicks and then puffs up by evening is telling a different story from a joint that clicks and stays the same size. A phone photo of both knees side by side, taken at the same time of day, is an easy way to show the difference.
What the exam does with the noise
An examiner usually tries to reproduce the sound under their hands. They move the joint slowly through its range, feel for the grinding or the click, compare it with the other side, and check the structures around it: the ligaments that hold the joint steady, the surfaces where the bones glide, the tendons that cross it. The National Institute of Arthritis and Musculoskeletal and Skin Diseases describes bursitis and sprains and strains in plain language, and both are among the kinds of problems a clinician keeps in mind around a joint that has started to complain. Whether either has anything to do with your joint is a question for the exam.
If the findings call for imaging or a different specialty, a straight answer about that belongs in the visit. Missouri Injury Clinic publishes its auto injury lane as diagnosis and a treatment plan after a crash; Entry 06 has what the first visit includes.
A short script for the visit
"Since the crash on the 14th, my left knee clicks going down stairs. It hurts when it clicks. Twice it has caught halfway and I had to straighten it slowly. It swells a little by evening. My right knee has always cracked a bit, and that has not changed."
That is five sentences. It names the date, the joint, the movement, the pain, the catch, the swelling, and the old noise that is not part of the story. An examiner can start testing from it immediately.
What not to do
Do not keep cracking the joint to check whether the noise is still there. Do not look up the sound and bring a conclusion instead of a description. And do not hold off on the exam because the noise seems too small to mention. The Journal's joint inventory exists because small complaints are the ones that get left off the list, and a noise with pain attached is not small.
The bright line still comes first. Chest pain, a sudden severe headache, weakness or numbness on one side, trouble speaking, a loss of bowel or bladder control, or a head injury with vomiting or worsening confusion is an emergency room trip right now. So is a joint you cannot put weight on, or one that looks out of place.
The standing prescription
Bring the description to an exam this week. The Tesson Ferry office is at 11144 Tesson Ferry Road, Suite 200, (314) 530-5480, open Monday through Thursday 9am to 6pm and Friday 9am to 12pm, closed from 12 to 2 daily. Hazelwood and O'Fallon cover the rest of the metro; Entry 09 lists all three with hours.