Knee Pain
CITRUS
C
Crackles on movement
I
Infection
T
Truama/ Tick bite
R
Redness/ rash
U
Ulcer in mouth
S
Swelling, Stiffness, STD History
PHYSICAL EXAMINATION for Knee Pain:
Hair & Skin exam: Inspection
Mouth:
Inspection, Look for ulcers to rule out SLE
Musculoskeletal exam:
Inspection, Palpation, ROM of both knees and other joints.
Cardiovascular exam:
Auscultation
Pulmonary exam:
Auscultation
DIFFERENTIAL DIAGNOSIS for Knee Pain:
Osteoarthritis:
Risk factor: age, repetitive movement. morning stiffness, crackles on movement.
Rheumatoid arthritis:
Joint pain for longer than 6 weeks duration, red, warm joints. morning stiffness, swelling.
Gout:
Acute joint pain, Red, warm to touch, swelling, stiffness, history of binge beer drinking, history chemotherapy.
Pseudogout:
Acute join pain, Red, warm to touch, swelling, stiffness, associated with hyperparathyroidism, hypothyroidism, hemochromatosis.
Systemic lupus erythematosus (SLE):
Joint pain, malar rash, oral ulcer, alopecia
Septic arthritis:
Acute joint pain, red joint, warm to touch, swelling, stiffness of the joint, fever.
Gonococcol arthritis:
Sexual active person, STD Hx, skin rash, Acute joint pain, red joint, warm to touch, swelling, stiffness of the joint, fever.
DIAGNOSTIC WORKUP for Knee Pain:
CBC
ANA, Anti-dsDNA, Rheumotoid factor
Pelvic examination
Cervical culture
Blood culture
Knee aspiration & Synovial fluid analysis
XR of knee