Overuse Injuries of the Knee

Overuse injuries of the knee represent a broad spectrum of disorders resulting from repetitive mechanical loading and failed tissue adaptation. These conditions commonly affect athletes and physically active individuals and may involve tendons, cartilage, bone, and periarticular soft tissues. Imaging plays a central role in diagnosis, with radiographs and ultrasound providing initial assessment, and MRI offering the highest sensitivity for early and subtle abnormalities. A wide range of entities may be encountered, including extensor mechanism tendinopathies, traction apophysitis in the immature skeleton, friction syndromes, synovial and fat pad impingement, medial bursitis, and bone stress injuries. Many of these conditions share overlapping clinical presentations and may mimic intra-articular pathology, particularly meniscal disease. Understanding the underlying biomechanical mechanisms and recognizing characteristic imaging patterns are essential for accurate diagnosis and appropriate management. This review provides a comprehensive overview of overuse injuries of the knee, emphasizing imaging findings, anatomical distribution, and key differential considerations to improve diagnostic accuracy and clinical relevance.