“Comprehenssive Case Study: 83-Year-Old Female – Week 9 i Human Simulation | Reason for Encounter: Knee Pain | Setting: Outpatient Clinic with X-Ray, ECG, and Laboratory Capabilities”

i-Human Case Week #9 — 83-Year-Old Female with Knee Pain Setting: Outpatient clinic with X-ray, ECG, and laboratory capabilities Authored by Student Nurse 1⬛ Case Overview / What’s Wrong With the Patient Chief Complaint: “My right knee hurts when I walk.” Duration: 2 months, gradually worsening Onset & Pattern: Insidious; stiffness on waking or after sitting, relieved after a few minutes of movement Character: Dull, aching pain that intensifies with walking or climbing stairs Location: Medial aspect of right knee, non-radiating Associated Symptoms: Morning stiffness (< 30 min), mild swelling; denies redness, fever, chills, or trauma Functional Impact: Uses a cane; limited mobility and household independence Initial Impression (Exploratory Differential List) Differential Rationale / Typical Features Relevance to Case Osteoarthritis (OA) Gradual onset, age > 60 yrs, joint- space loss, stiffness < 30 min Highly likely Rheumatoi d Arthritis (RA) Bilateral symmetric joints, systemic features Unlikely (mono- articular) Gout / Pseudogout Sudden severe pain, erythema, warmth Unlikely (chronic course) Septic Arthritis Fever, redness, elevated WBC No infection signs Osteopor otic Fracture Acute pain after trauma No injury Bursitis / Tendinitis Local tenderness without stiffness Possible but less likely ⬛ Most Likely Diagnosis: Primary Osteoarthritis of the Right Knee (M17.11) ⬛³ Assessment Questions and Patient Responses Question Answer When did the pain begin? “About two months ago.” What makes it worse? “Walking and climbing stairs.” What relieves it? “Rest and a warm compress.” Any history of fall or trauma? “No.” Morning stiffness duration? “Maybe 10 minutes.” Any redness or warmth? “No.” Fever or chills? “No.” Do other joints hurt? “Just this knee.” Have you used medication? “Only acetaminophen sometimes.” Any previous joint disease? “No, first time.” Family history of arthritis? “My mother had arthritis too.”