7/10/2017 11. 74-year-old female with knee pain - Ms.

Roman

11. 74-year-old female with knee pain - Ms. Roman Gandham Gautami Help
Jump to: Card Top Engagement:

As you make your way to the exam room, you compare and contrast some of the features of dierent
causes of knee pain:

Dierential Diagnosis for Knee Pain

Diagnosis Location of pain History of Fever Special notes

trauma
Systemic
symptoms

Patellofemoral Anterior knee pain No; overuse No Typically presents in

Pain Syndrome injury more likely women as "theater sign"-
mild to moderate anterior
(chondromalacia knee pain, worse after
patellae) prolonged sitting

Iliotibial Band Lateral knee pain No; overuse No No eusion

Tendonitis injury more likely
(repetitive knee Pain aggravated with
exion) activity
Anterior General knee pain Yes; noncontact No Moderate to severe joint
Cruciate deceleration eusion
Ligament forces
Sprain Swelling within two hours
of "pop"
Medial Medial joint line pain Yes; misstep or No Immediate onset of
Collateral collision pain/swelling after trauma
Ligament
Sprain
Lateral Lateral joint line pain Yes; varus stress No Immediate onset of lateral
Collateral knee pain
Ligament
Sprain Less common than medial
collateral ligament sprain
Meniscal Tear Medial or lateral joint line Yes; sudden No Can occur with chronic
twisting injury degenerative process

Mild eusion

Possible atrophy of the

vastus medialis obliquus
portion of the quadriceps

Catching/locking of the
knee

Can have positive

McMurray test
Septic arthritis Generalized extreme pain No Yes Abrupt onset of pain and
with any movement swelling
Elevated
WBC Arthrocentesis with turbid
Expert synovial uid
Elevated
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7/10/2017 11. 74-year-old female with knee pain - Ms. Roman
Elevated
ESR
11. 74-year-old female with knee pain - Ms. Roman (usually
>50
Jump to: Card Top mm/hr) Engagement:
Osteoarthritis Generalized or joint line Not acute No Chronic joint stiness and
tenderness; pain trauma. pain

aggrevated by weight-
bearing activities, Past history of Crepitus on exam
relieved by rest trauma can
predispose to Mild or no joint eusion
developing
osteoarthritis
Gout / Extreme pain with any No No Acute pain and swelling
pseudogout movement; also painful without prior trauma
to touch
Arthrocentesis with clear or
slightly cloudy synovial
uid

Negatively birefringent rods

in gout

Positively birefringent
rhomboids in pseudogout
Popliteal Posterior popliteal area No No Insidious onset of mild to
(Baker's) Cyst moderate pain in the
popliteal area of the knee

Most common synnovial

cyst of the knee

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