Table 2.

Differential Diagnosis of Posteromedial Knee Pain ^a

Differential Diagnosis	Comments
Semimembranosus muscle tear	History of acute injury. Imaging: radiograph for avulsion, MRI for soft tissue
Medial collateral ligament injury	History and examination. Valgus stress pain and laxity
Medial meniscal tear	History, clinical examination, MRI. May be concomitant with SMT
Femoral/tibial osteonecrosis	Joint pain. Imaging: Abnormal radiographs, CT, MRI
Pes anserine bursitis	Located more anteriorly and distally than SMT, medial to tibial tuberosity
Bony stress reaction/fracture	Examination: localized pain. MRI
Baker (popliteal) cyst	Examination: posterior mass. Imaging: MRI scan
Semimembranosus bursitis	Clinical examination and MRI scan
Osteoarthritis (medial)	Joint line pain. Imaging: changes on radiographs, CT, MRI
Snapping knee syndrome	Palpable snap between semitendinosus and gracilis
Tumor/infection	History, red flags, imaging, blood laboratory results

^a CT, computed tomography; MRI, magnetic resonance imaging; SMT, semimembranosus tendinopathy.