I had a couple of back to back cases of the same “mysterious” problem, always a sign for me that I will be writing a new blog.
In both instances the patient had pretty localized pain on the outside of the knee, and it both instances, the pain had been elusive to treat and diagnose. Imaging was normal for damage to the cartilage and meniscus on the outside of the knee, it was being treated as an iliotibial band problem and not responding.
The fibula is a long thin bone that attaches to the tibia just below the main join on the outside of the knee. The attachment on the upper part of the tibia is a small cartilage joint with very tight ligaments and very little movement. The attachment to the lower part of the leg at the ankle has a lot more movement. The lower part of the fibula makes up the lateral ankle bony prominence known as the lateral malleolus.
The upper fibular head can be misaligned like any other joint, but the problem almost always starts at the ankle, with an ankle inversion ( “rolling “ ) sprain, that creates a sudden upwards and lateral/anterior force to the upper joint. This would also explain why patients with fibular head dysfunction are always so dumbfounded about the origin of the pain as they do not recall any trauma to the knee, until someone asks them about a specific recent ankle sprain. The good news is that the pain usually responds really well to a few adjustments with no residual long term problems.
