MKSAP: 52-year-old man with gradually progressive left knee pain

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 52-year-old man is evaluated for a 5-year history of gradually progressive left knee pain. He has 20 minutes of morning stiffness, which returns after prolonged inactivity. He has minimal to no pain at rest. He reports no clicking or locking of the knee. Over the past several months, the pain has limited his ambulation to no more than a few blocks. On physical examination, vital signs are normal. BMI is 25. The left knee has a small effusion and some fullness at the back of the knee; the knee is not erythematous or warm. Range of motion of the knee elicits crepitus. There is medial joint line tenderness to palpation, bony hypertrophy, and a moderate varus deformity. There is no evidence of joint instability on stress testing. Radiographs of the knee reveal bone-on-bone joint-space loss and numerous osteophytes. Which of the following is the most appropriate next diagnostic step for this patient? A: CT of the knee B: Joint aspiration C: MRI of the knee D: No diagnostic testing 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: Family Physicians Tags: Conditions orthopedics Source Type: blogs