A 59 y.o. male in town for a conference comes to the urgent clinic with severe right knee pain. His knee was fine yesterday when he played nine holes of golf. He describes a history of osteoarthritis in both knees for which he takes celecoxib. Also, about a month earlier, he got an injection in his right knee that resulted in decreased pain and asks if another knee injection would help. This pain is now much worse than last month; this time his knee is very red and swollen. He does not recall an injury and has never experienced a similar pain in any joint.
Past Medical History
Family History
Psychosocial History
Eats three meals daily, most of which are eaten out, and eats “more sweets than I should.” Habits include approximately one-half a pack of cigarettes per day and two to three beers daily. Tries to walk 20 minutes every day to help keep his weight down but comments “I sure won’t be walking with this.”
Physical Examination
Questions
1. It can be due to a torn meniscus, as he is already having osteoarthritis. Excess strain and stress on the knee during the game can aggravate the existing problem. During the game he has to bend down to take the ball and also has to rotate the knee during golf swing. All these can exacerbate the pain.
2. Gout can be suspected as it is single inflammation of joint. Here the client complaint of pain over right knee.
3.soft tissue disease some time it can be due to soft tissue disease. For example muscle strain or bursitis tendinitis.
A detailed examination is needed. The patient is diabetic so blood glucose levels should be assessed, MRI to find out the exact cause, uric acid should be checked to find out if gout is present. X-ray to find out lateral subluxation of tibia Arthroscopy to find out extent of damage to the joints.
A 59 y.o. male in town for a conference comes to the urgent clinic with severe...
Chief Complaint: Knee Pain History of Present Illness A 59 y.o. male in town for a conference comes to the urgent clinic with severe right knee pain. His knee was fine yesterday when he played nine holes of golf. He describes a history of osteoarthritis in both knees for which he takes celecoxib. Also, about a month earlier, he got an injection in his right knee that resulted in decreased pain and asks if another knee injection would help. This...
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