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Knee pain

  • Trauma ddx

    • torn meniscus
    • hemarthrosis
    • collateral ligaments: ACL, PCL, MCL, LCL
    • fracture
  • Common non-traumatic ddx

    • osteoarthritis (crepitus)
    • rheumatoid arthritis
    • bursitis
    • gout, pseudogout
    • hemophilia (easy bleeding, bruising)
    • Baker's cyst (behind knee)
  • Ottawa rules. Get an xray if any one of

    • age > 55
    • fibula head tenderness
    • isolated patella tenderness
    • unable to flex to 90 deg
    • unable to ambulate 4 steps
  • Labs

    • CBC, Chem
    • ESR, ASO, ANA
    • UA
    • joint aspiration if suspect infection or gout
  • Tx for uncomplicated knee pain

    • RICE (rest, ice, compression, elevation), tylenol
  • Serious ddx

    • patella fracture
    • rheumatic fever
    • septic arthritis (fever)
    • sarcoma
    • referred pain from the hip
  • Rare ddx

    • Osgood Schlatter (tibia plateau tenderness)
    • reiter's (urethral discharge)
    • lupus
  • HPI

    • onset
    • triggering event, trauma
    • location
    • unilateral vs bilateral
    • quality
    • severity
    • pain at night, ability to ambulate
    • aggravates
    • alleviates: ability to alleviate with OTCs
  • ROS

    • fever, weight loss
    • chest pain, dyspnea
    • nausea, vomiting, diarrhea
    • dysuria, discharge
    • hip pain, ankle pain
    • easy bleeding, bruising
  • PMH

    • hemophila
    • gout
    • arthritis
  • FH

  • SH

    • running
  • Meds

  • Allergies

  • General Px

    • vitals
    • gen impression
    • cardio, pulm, GI
    • neuro
  • Knee px

    • inspection: erythema, deformity
    • palpation: knee cap, joint line, tibia plateau, fibula head
    • check pedal pulse
    • strength and ROM of the hip, knee, and ankle
    • sensation of distal extremity
    • reflex if possible
    • test collateral ligaments: drawer's, valgus and varus
    • test meniscus: McMurry's (extension + rotation produces click)
    • ability to ambulate

  • Print | Citations

    Disclaimer: MDHero Workups is for educational use only, and is not meant to replace the clinical judgement of a professional. We do not guarantee the accuracy of any information on this website.