Case 11: 74-year-old female with knee pain,
QUESTION AND ANSWERS 2023-2024
ALREADY PASSED!!!
A patient presents to you with mild-moderate anterior knee pain worse after
prolonged sitting. Diagnosis?
Patellofemoral Pain Syndrome
A patient presents to you with lateral knee pain, there is no effusion, and pain is
worse with activity. Diagnosis?
Iliotibial Band Tendonitis
A patient presents to you with general knee pain with moderate-severe effusion,
and swelling within 2 hours of hearing a "pop" while playing soccer. Diagnosis?
ACL sprain
A patient presents to you with medial joint line pain that had immediate onset
and swelling after a collision during soccer. Diagnosis?
MCL sprain
A patient presents to you with lateral joint line pain that had immediate onset
and positive varus stress test. Diagnosis?
LCL sprain
,A patient presents to you with medial or lateral joint line pain with mild effusion
after awkwardly twisting leg during soccer. The patient complains of
catching/locking of the knee and has a positive McMurray test. Diagnosis?
Meniscal tear
A patient presents to you with generalized extreme pain with any movement that
had abrupt onset and swelling. Patient also has a fever and elevated WBC and
ESR. Diagnosis?
Septic arthritis
A patient presents to you with generalized or joint line tenderness and pain is
aggravated by weight-bearing activities, but relieved by rest. No hx of acute
trauma but does have hx of chronic joint stiffness and pain. No effusion.
Diagnosis?
Osteoarthritis
A patient presents to you with extreme pain in knee with any movement and also
painful to touch. Acute onset of pain and swelling with no hx of acute trauma.
Diagnosis?
Gout
A patient presents to you with mild-moderate posterior popliteal area pain with
insidious onset. No hx of acute trauma. Diagnosis?
Popliteal (Baker's) Cyst
, Arthrocentesis findings in gout vs septic arthritis =
Gout = clear or slightly cloudy synovial fluid with presence of crystals (calcium
pyrophosphate or monosodium urate)
Septic arthritis = turbid synovial fluid with lots of inflammatory cells
POSITIVE or NEGATIVE birefringent rods in gout?
NEGATIVE birefringent rods
POSITIVE or NEGATIVE birefringent rhomboids in pseudogout?
POSITIVE birefringent rhomboids
Crepitus on knee exam =
a grating sound or sensation produced by friction between bone and cartilage or
the fractured parts of a bone
This is the normal range of motion for the knee (flexion and extension) =
- 0 degrees extension
- 135 degrees flexion
QUESTION AND ANSWERS 2023-2024
ALREADY PASSED!!!
A patient presents to you with mild-moderate anterior knee pain worse after
prolonged sitting. Diagnosis?
Patellofemoral Pain Syndrome
A patient presents to you with lateral knee pain, there is no effusion, and pain is
worse with activity. Diagnosis?
Iliotibial Band Tendonitis
A patient presents to you with general knee pain with moderate-severe effusion,
and swelling within 2 hours of hearing a "pop" while playing soccer. Diagnosis?
ACL sprain
A patient presents to you with medial joint line pain that had immediate onset
and swelling after a collision during soccer. Diagnosis?
MCL sprain
A patient presents to you with lateral joint line pain that had immediate onset
and positive varus stress test. Diagnosis?
LCL sprain
,A patient presents to you with medial or lateral joint line pain with mild effusion
after awkwardly twisting leg during soccer. The patient complains of
catching/locking of the knee and has a positive McMurray test. Diagnosis?
Meniscal tear
A patient presents to you with generalized extreme pain with any movement that
had abrupt onset and swelling. Patient also has a fever and elevated WBC and
ESR. Diagnosis?
Septic arthritis
A patient presents to you with generalized or joint line tenderness and pain is
aggravated by weight-bearing activities, but relieved by rest. No hx of acute
trauma but does have hx of chronic joint stiffness and pain. No effusion.
Diagnosis?
Osteoarthritis
A patient presents to you with extreme pain in knee with any movement and also
painful to touch. Acute onset of pain and swelling with no hx of acute trauma.
Diagnosis?
Gout
A patient presents to you with mild-moderate posterior popliteal area pain with
insidious onset. No hx of acute trauma. Diagnosis?
Popliteal (Baker's) Cyst
, Arthrocentesis findings in gout vs septic arthritis =
Gout = clear or slightly cloudy synovial fluid with presence of crystals (calcium
pyrophosphate or monosodium urate)
Septic arthritis = turbid synovial fluid with lots of inflammatory cells
POSITIVE or NEGATIVE birefringent rods in gout?
NEGATIVE birefringent rods
POSITIVE or NEGATIVE birefringent rhomboids in pseudogout?
POSITIVE birefringent rhomboids
Crepitus on knee exam =
a grating sound or sensation produced by friction between bone and cartilage or
the fractured parts of a bone
This is the normal range of motion for the knee (flexion and extension) =
- 0 degrees extension
- 135 degrees flexion
