[Chronic knee pain in children and adolescents: review of anatomical and overload-related knee pain].

BACKGROUND: Knee pain in children and adolescents is a common reason for presentation in pediatric orthopedic consultation. The causes are manifold and require a thorough patient history, detailed physical examination and extensive diagnostics. DIAGNOSTICS: Chronic knee pain in children and adolescents is a diagnosis by exclusion. An extensive patient history including training habits, pain localization and clinical examination provide indications vital for the diagnosis. Overuse is often the trigger. In dynamic investigations consideration should be given to muscle imbalance. Imaging techniques have a high sensitivity and specificity only in combination with the anamnesis and clinical findings. THERAPY: With pain therapy, targeted physiotherapy, a break in active sport or training modifications, the prognosis is good for overload syndromes. An operative therapy after unsuccessful conservative therapy is necessary in only a few cases. Among the anatomy-related types of knee pain primary popliteal cysts mostly require no therapy and for plica syndrome arthroscopic resection should only be necessary if conservative treatment is unsuccessful. Operative therapy is necessary for symptomatic discoid meniscus.