Genicular Nerve Block for Knee Pain in the ED

Inclusion Criteria: * Atraumatic knee pain * \>17 years age * X-ray of the knee obtained in the ED * Initial pain score (numeric rating scale) 5-10 Exclusion Criteria: * Fracture or dislocation on x-ray * large knee joint effusion identified on x-ray * allergy or contraindication to local anesthetics * History of local anesthetic systemic toxicity after receiving local anesthetics * Pregnancy * Incarcerated * History of knee replacement of affected knee * Concern for septic joint * Overlying cellulitis * Hemodynamic instability * Altered mental status or inability to consent for procedure.