Patient guides to orthopedic decisions
Patient guides to orthopedic decisions
Medical information is useful when it helps you recognize the questions that matter in a consultation. These guides explain body-region problems, treatment choices and preparation for a second opinion.
Assessment
Navigate the medical questions
Start with the area that is painful or the decision already proposed. A condition guide explains the clinical background; a second-opinion page focuses on reviewing a recommendation, alternatives and missing information.
Next steps
Use information in context
Read the information alongside your own medical advice, not as a personal diagnosis. The German knowledge archive contains additional long-form articles. Where an article has not been translated, its language is identified rather than silently changing your selected language.
Medical specialties
Knee
Knee specialist in Munich
Knee pain can arise from the meniscus, ligaments, cartilage, tendons or the joint itself. A useful diagnosis explains both the symptoms and the difficulty with walking, stairs, running or sport. An MRI finding alone does not decide whether treatment or surgery is needed.
Meniscus tear
Not every meniscus tear requires an operation. A recent traumatic tear, a displaced fragment and a degenerative change have different implications. Location, tear pattern, knee symptoms and the surrounding cartilage matter more than the word ‘tear’ in a report.
ACL injury
An anterior cruciate ligament injury affects rotational stability of the knee. The choice between rehabilitation and reconstruction depends on giving-way episodes, associated injuries and the demands of work and sport. Age or an MRI diagnosis alone is not enough to choose a pathway.
Knee cartilage injury
A focal cartilage defect is different from widespread osteoarthritis. Symptoms depend on the location and extent of damage, underlying bone and how the knee carries load. The grade in an MRI report is only one part of the assessment.
Knee osteoarthritis and knee replacement
Osteoarthritis treatment should reflect pain, function and daily priorities, not an X-ray grade alone. The affected compartment, leg alignment, ligament stability and the response to previous treatment determine which options are worth discussing.
Patellar tendinopathy
Pain at the lower tip of the kneecap during jumping, acceleration or stairs can come from the patellar tendon. Tendon pain is not simply a problem to rest away: the relationship between current load and tendon capacity is central.
Patellofemoral pain
Pain around or behind the kneecap often appears during stairs, squats, running or prolonged sitting. It can occur without major cartilage damage. A scan should therefore not replace an assessment of movement, strength and current training load.
Patellar instability
A kneecap that dislocates or repeatedly feels unstable needs a different assessment from ordinary anterior knee pain. The first episode, recurrent dislocation and persistent apprehension are not interchangeable situations. Associated cartilage injury can influence the urgency and type of treatment.
Knee pain during sport
Running, jumping and turning challenge the knee in different ways. Pain may reflect a training-load problem, tendon symptoms, patellofemoral pain or an injury inside the joint. The timing and location of symptoms help direct the assessment.
Bone marrow oedema in the knee
Bone marrow oedema describes an MRI signal, not one single disease. It may occur after trauma, with overload, osteoarthritis or an insufficiency fracture. The cause matters because continuing impact loading may be inappropriate in some situations.
Medical specialties
Shoulder
Shoulder specialist in Munich
Shoulder pain can involve tendons, the joint capsule, cartilage or instability. Pain when lifting the arm, loss of strength and restricted movement suggest different problems. Neck-related symptoms can also resemble a shoulder disorder.
Rotator cuff tear
A rotator cuff tear may develop gradually or follow an injury. Symptoms range from manageable pain to substantial weakness. Tear size alone does not determine the best treatment: tendon quality, muscle changes, function and personal goals also matter.
Supraspinatus tendon tear
The supraspinatus is one of the rotator cuff tendons and contributes to lifting and stabilizing the arm. A partial-thickness lesion and a full-thickness tear require different interpretation. Some MRI changes are not the main source of pain.
Shoulder instability
Shoulder instability can follow a dislocation or occur repeatedly during particular movements. Traumatic instability, generalized joint laxity and movement-control problems are different conditions. The number of episodes and the demands of contact or overhead sport affect the decision.
Shoulder impingement and subacromial pain
‘Impingement’ is often used for pain when raising the arm, but it does not identify one single mechanical cause. Rotator cuff load tolerance, bursal irritation and movement factors may contribute. The diagnosis should explain the symptoms rather than merely describe a narrow space.
Calcific shoulder tendinopathy
Calcium deposits in a rotator cuff tendon can be incidental or cause considerable pain. Symptoms may fluctuate and can become intense during a resorptive phase. Deposit size on its own does not determine the treatment needed.
Frozen shoulder
Frozen shoulder is characterized by pain and restriction of both active and passive movement. It differs from being unable to lift the arm because of weakness alone. The course can be prolonged and the current irritability influences what treatment is tolerable.
SLAP lesion
A SLAP lesion involves the upper labrum near the attachment of the long biceps tendon. MRI changes can also reflect age-related variation. Pain in an overhead athlete therefore needs a clinical explanation before a scan finding is treated.
Acromioclavicular joint pain
The AC joint connects the collarbone to the shoulder blade. Local pain on top of the shoulder may arise from arthritis, an injury or repetitive loading. It needs to be distinguished from pain in the main shoulder joint or rotator cuff.
AC joint osteoarthritis
Arthritic changes at the small joint on top of the shoulder are common on imaging and are not always painful. Pain with cross-body reach, bench pressing or particular overhead tasks can suggest a symptomatic AC joint.
AC joint separation
A fall onto the shoulder can injure the ligaments supporting the collarbone. Visible displacement does not tell the whole story: horizontal instability, pain, timing and occupational or sporting demands affect treatment decisions.
Long head of the biceps tendon
The long biceps tendon can cause pain at the front of the shoulder and may be affected together with the rotator cuff or labrum. Tendon irritation, instability and rupture have different consequences for function and treatment.
Shoulder osteoarthritis and replacement
Shoulder osteoarthritis can limit movement, sleep and daily activities. Considering a replacement requires more than confirming cartilage loss. Pain severity, remaining function, rotator cuff integrity and the shape of the socket affect the available options.
Medical specialties
Elbow
Elbow specialist in Munich
Elbow pain can arise from tendons, nerves, cartilage or instability. Lateral tendon pain, medial pain and a sudden loss of lifting strength should not be treated as the same diagnosis. Work tasks and sporting movements often help localize the problem.
Tennis elbow
Tennis elbow usually causes pain near the outer elbow during gripping or wrist loading. It also affects people who do not play tennis. Tendon capacity, repetitive work and recent changes in load are often more relevant than the activity’s name.
Golfer’s elbow
Pain at the inner elbow may involve the flexor-pronator tendon attachment, but not every medial elbow problem is golfer’s elbow. In throwing athletes, the stabilizing ligament deserves attention; tingling into the ring and little fingers suggests a possible nerve component.
Distal biceps tendon tear
The distal biceps tendon helps bend the elbow and turn the palm upwards. A sudden painful event with bruising and loss of rotational strength can indicate a tear. Partial and complete tears have different implications.
Medical specialties
Foot and ankle
Foot and ankle specialist in Munich
Pain after an ankle sprain, recurring instability, heel pain and tendon overload require different approaches. The foot and ankle must be considered as a functional unit, including alignment, footwear and the demands of walking or sport.
Achilles tendon pain and injury
Midportion tendinopathy, insertional pain and an Achilles rupture are different diagnoses. Gradual load-related pain should be distinguished from a sudden snap with loss of push-off strength. The location and onset guide the next steps.
Plantar fasciitis and heel pain
Pain under the heel with the first steps after rest can fit plantar fascia-related pain. A heel spur on an X-ray does not automatically explain the symptoms. Bone stress injury, nerve irritation and other causes must be considered when the pattern is atypical.
Peroneal tendon disorders
The peroneal tendons run behind the outer ankle and help stabilize the foot. Pain, swelling or snapping in this area may involve overload, a tear or tendon instability. These problems can persist after an ankle sprain.
Posterior tibial tendon dysfunction
The posterior tibial tendon helps support the arch and control the foot during walking. Pain behind the inner ankle may occur before a visible change in foot shape. Increasing flattening or difficulty with a single-leg heel rise needs careful assessment.
Medical specialties
Spine
Back and neck pain
Back or neck pain can have muscular, joint-related or nerve-related causes. Common scan findings do not always explain symptoms. An assessment should connect the pain pattern, neurological function and the effect on daily life.
Herniated disc and surgery decisions
A herniated disc is clinically relevant when its location and effect on a nerve fit the symptoms. Disc changes without corresponding complaints are a different situation. The urgency depends especially on neurological function, not just the size described in an MRI report.
Medical specialties
Sport and other regions
Hip pain
Groin pain, lateral hip pain and buttock pain can come from different structures. Joint disease, tendon problems and referred spinal pain may overlap. The assessment should identify the limiting problem before attributing every symptom to an MRI finding.
Muscle and tendon injuries in sport
A muscle strain, a larger tear and a tendon avulsion have different recovery paths. Location, the involvement of connective tissue and the demands of the sport matter alongside pain. A return based only on a fixed number of days can miss persisting deficits.
Stress fractures and bone overload
Bone stress injury occurs when repeated loading exceeds the bone’s current capacity. A stress reaction and a complete fracture represent different points on a spectrum. Some locations carry greater risk and need prompt protection.
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