An Uncommon Cause Of Chronic Knee Pain - Page #1

Author: Jeffrey Peng, MD
Co Author #1: Michael Henehan, DO

Patient Presentation:
58 year old male presented with two years of right posteromedial knee pain.

He presented to the clinic complaining of 2 years of right knee pain. He stated that nothing improved his pain. He had no radiation of pain, locking, clicking, numbness, or tingling. He also had no history of trauma. He stated that pain is worsened with walking and exercising. Initially, his primary care physician ordered x-rays two years ago and referred him to physical therapy. He then had an MRI and subsequent arthroscopic surgery including menisectomy, removal of a foreign body, and cleaning of chondromalacia. Over the next few months, he noted minor improvements in his knee but still had persistent pain. Related history includes a right lower extremity DVT three years ago which was treated with anticoagulation for one year. He also had venous ablation of the right lower extremity for varicose veins in 2016. He notes that his knee pain started after his ablation procedure but was told by his cardiologist that it was unrelated.

Physical Exam:
Right knee exam: No warmth, erythema, or effusion. Right knee with full range of motion. 5/5 strength with flexion and extension. Negative patellar grind or apprehension. No joint line tenderness. No laxity or pain with varus or valgus stress testing. Negative Lachman's, anterior drawer, and posterior drawer. Negative McMurray's. Tenderness to palpation on the posteromedial aspect of the knee proximal to the insertion of the semimembranosus tendon.

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