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Serious injuries, by and large, cause a lot of swelling in the knee. Especially in younger patients. Now, someone could be arthritic and they overdo it going for a big long hike and they get some swelling the next day. But rapid onset of swelling, it's like hard to make out where your kneecap is, is a pretty big cardinal sign that there's something serious that's happened to your knee. Rapid onset swelling is usually due to blood in the joint. "A meniscus that really tears and flips in the front. You tear your quad or your patellar tendon, your kneecap dislocates, you tear a little blood vessel, your ACL tears, a piece of cartilage in bone gets knocked off and causes bleeding. So a lot of the really significant injuries, people get rapid onset swelling within three to four hours and they should seek attention There's always exceptions to rules, but if your knee looks like a grapefruit, you should go get it checked.

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