[##]-year-old [male/female] with [right/left] knee pain with history and
exam consistent with likely patellofemoral pain syndrome (“runner’s knee”).
Initial consideration in this patient included knee dislocation,
patellar and other knee fractures, patellar and quadriceps tendon injury or
rupture, meniscus and ligamentous knee injuries, arthritis, Osgood-Schlatter
disease, pes anserine and prepatellar bursitis, and septic arthritis amongst
others.
Patient presented with report of gradual onset of unilateral, anterior,
non-radiating knee pain that is reportedly worsened by prolonged knee flexion
(“moviegoer syndrome”) and stair climbing.
Patient noted to have a positive patellar grind test of the [right/left]
knee (press patella away from femoral condyles while patient contracts the
quadriceps; sudden patellar pain and relaxation of the muscle is a positive
test). Plain films were considered
[unnecessary in patient without significant history of trauma, bony tenderness
or deformity, or other findings suggestive of dislocation, fracture or other
significant injury/and obtained with no evidence of significant abnormality/obtained
and notable for a patella that does not line up with the groove of the femur on
sunrise view/decreased space posterior to patella/bony erosions].
Prior to discharge, we discussed return precautions, symptomatic
treatment with rest, ice, compression, and exercises as described in the
handout provided at time of discharge, and follow up with primary care doctor
within one week for further evaluation and consideration of referral to
physical therapy, and the patient demonstrated understanding and agreement.
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