MKSAP: 48-year-old man with knee pain and swelling

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 48-year-old man is evaluated for a 2-day history of right anterior knee pain and swelling. The pain began suddenly and has increased in intensity. He currently rates his pain as an 8 on a 10-point scale. He has no knee instability and reports no fever or chills. He has no history of trauma and has never had this problem before. Other than his right knee pain and swelling, he feels well. He is employed as a carpet layer. His only medication is ibuprofen, which provides minimal relief. On physical examination, vital signs are normal. BMI is 28. On examination of the right knee, there is a palpable fluid collection that is located anterior to the patella. The right knee has full range of motion. There is no medial or lateral joint line tenderness or laxity with varus or valgus forces. Anterior drawer, posterior drawer, and Lachman tests are all negative. Which of the following is the most appropriate next step in management? A. Aspiration B. Compression C. Glucocorticoid injection D. Right knee radiographs E. Ultrasound Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Conditions Orthopedics Rheumatology Source Type: blogs