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Beyond The Serology - Page #1
 

Author: Hamreet Baidwan, MBBS
Co Author #1: Niki Shahrrava, MD
Co Author #2: Donghoon Lee, MD
Co Author #3: Conan Chittick, MD
Senior Editor: Drew Duerson, MD
Editor: Rukayat Balogun, MD

Patient Presentation:
Intermittent bilateral knee swelling

History:
A 31-year-old male snowboarder presented for evaluation of right knee pain and swelling.

He reported intermittent bilateral knee pain and swelling for several months without a known injury or inciting event. He had difficulty with knee extension and was using crutches for ambulation due to the severity of the right knee swelling.

He denied a history of prior injuries involving either knee. He had trialed oral ibuprofen and over-the-counter topical pain medications without relief. He denied recent travel to areas with tick exposure or other infectious risk factors. He also denied a family history of gout or inflammatory arthritis and reported being in a monogamous relationship.

Physical Exam:
Vital Signs: Blood Pressure 113/76, Heart Rate 80.

Right Knee
Inspection: Antalgic gait with crutches. Swelling present.
Palpation: Diffuse tenderness along the medial and lateral joint lines.
ROM: Flexion 125 (135); Extension 10 (0). Strength: 5/5 with extension and flexion.
Special Tests: Positive patellar grind test, unable to perform further testing due to swelling and intolerance to exam secondary to pain.

Left Knee
Inspection: Swelling present.
Palpation: Diffuse tenderness along the medial and lateral joint lines and superior patellofemoral region.
ROM: Flexion 125 (135); Extension 10 (0).
Strength: 5/5 with extension and flexion.
Special Tests: Positive patellar grind test, unable to perform further testing due to swelling and intolerance to exam secondary to pain.

Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.

NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.
 

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4000 W. 114th Street, Suite 100
Leawood, KS 66211
Phone: 913.327.1415


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