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BACKGROUND: Knee pain is among the most common reasons for consultations for musculoskeletal pain. The objective of this article is partly to provide an overview of the research undertaken in the area of atraumatic and degenerative knee pain, and partly to assess whether common practices for examination and treatment are consistent with this research. METHOD: This article is based on a selection of English-language studies of atraumatic and degenerative knee pain found through a search in Medline, manual searches in the lists of references in the articles, and literature suggested by Mendeley. Studies of gonarthrosis, degenerative meniscus injuries and the psychosocial context of knee pain were given preference. RESULTS: There is frequently little consistency between findings made by diagnostic imaging and the clinical picture, and an extra-articular origin may easily be overlooked. As a rule, symptomatic gonarthrosis may be diagnosed clinically. If there is a need for diagnostic imaging, standing x-ray images are the first choice. MRI scans are often used uncritically in cases of suspected arthrosis or meniscus injury, but this examination rarely produces clinically useful information. Activity-based forms of treatment yield results that are at least as good as arthroscopic surgery for degenerative knee pain and ought to be the first choice. Atraumatic knee pain is frequently associated with psychosocial problems, in particular in cases for which the clinical and radiological findings are modest. INTERPRETATION: Many patients with knee pain undergo examinations and therapies that are inconsistent with recent research results. Both the patient and society will be better served by a more evidence-based approach.

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