A 45-year-old man is sent to the ED by his primary care physician for unrelenting knee pain. He is otherwise healthy, has no history of trauma, and has no systemic symptoms. He ran his first half-marathon last week and states “I just can’t shake the pain”, “it feels swollen”, and “can I get my MRI now?”.
On exam, he has a normal if not slightly antalgic gait, with a normal knee exam except for a trace, non-ballotable effusion.
Regarding his management, which is the BEST answer:
A. Corticoid injection to knee joint and follow-up in a week
B. Knee brace and crutches until pain resolves
C. Plain films of the knee for occult injury
D. Reexamine his anterior knee and quadriceps
In the meantime, a quote --
"Disease is very old, and nothing about it has changed. It is we who change, as we learn and recognize what was formerly imperceptible."
De l’expectation en médecine
-- Jean Martin Charcot (1825-1893) Paris Neurologist
On exam, he has a normal if not slightly antalgic gait, with a normal knee exam except for a trace, non-ballotable effusion.
Regarding his management, which is the BEST answer:
A. Corticoid injection to knee joint and follow-up in a week
B. Knee brace and crutches until pain resolves
C. Plain films of the knee for occult injury
D. Reexamine his anterior knee and quadriceps
In the meantime, a quote --
"Disease is very old, and nothing about it has changed. It is we who change, as we learn and recognize what was formerly imperceptible."
De l’expectation en médecine
-- Jean Martin Charcot (1825-1893) Paris Neurologist
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