Comprehensive Clinical Case Study in
Musculoskeletal Medicine: Acute Knee Pain
Presentation—Patient: Tod Gouseau—with
Diagnostic Reasoning, Evidence-Based
Treatment, and Follow-Up Planning (2026)
Comprehensive Clinical Case Study – Musculoskeletal Medicine (2026)
Patient Profile
• Name: Tod Gouseau
, • Age: 57 years
• Sex: Male
• Occupation: Accountant (sedentary work with occasional recreational sports)
• Chief Complaint: Sudden onset of right knee pain
1. Chief Complaint
"My right knee suddenly started hurting this morning, and it’s swollen and difficult to bend."
2. History of Present Illness (HPI)
• Onset: Acute, started this morning after waking up.
• Location: Right knee, medial and anterior aspects.
• Quality: Sharp, throbbing pain.
• Severity: 7/10 on the pain scale.
• Timing: Constant, worse with movement.
• Exacerbating factors: Walking, stair climbing, bending the knee.
• Relieving factors: Rest, ice.
• Associated symptoms: Mild redness, swelling, warmth; no fever, no systemic symptoms.
• Previous episodes: None reported.
• Trauma: Denies falls, twisting injury, or sports-related trauma.
• Past medical history: Hypertension controlled with ACE inhibitor. No history of gout, diabetes, or
osteoarthritis.
• Medications: Lisinopril 10 mg daily.
• Allergies: NKDA.
• Family history: Father with osteoarthritis.
• Social history: Non-smoker, occasional alcohol, minimal exercise, BMI 30 kg/m².
3. Review of Systems (ROS)
, System Findings
Musculoskeletal Right knee pain, swelling, limited ROM
Constitutional No fever, fatigue, or weight loss
Cardiovascular No chest pain or palpitations
Respiratory No dyspnea, cough
Gastrointestinal No nausea, vomiting
Genitourinary No dysuria, hematuria
Skin Mild erythema over knee, no rash elsewhere
Neurologic No numbness, tingling, or weakness
4. Physical Examination
Vitals:
• BP: 132/80 mmHg
• HR: 78 bpm
• Temp: 36.8°C
• RR: 16/min
General: Alert, cooperative, no acute distress.
Right Knee Exam:
• Inspection: Swelling of the medial joint line, mild erythema, no ecchymosis
• Palpation: Warm, tender along medial and anterior joint line
• Range of Motion (ROM): 20–100° (limited by pain)
• Stability tests: Negative for valgus/varus stress pain; Lachman and anterior/posterior drawer
tests negative
• Effusion: Mild joint effusion, positive patellar tap
• Gait: Antalgic, favors right leg
Other Joints: No swelling, tenderness, or deformity in left knee, hips, ankles.
5. Differential Diagnosis
Musculoskeletal Medicine: Acute Knee Pain
Presentation—Patient: Tod Gouseau—with
Diagnostic Reasoning, Evidence-Based
Treatment, and Follow-Up Planning (2026)
Comprehensive Clinical Case Study – Musculoskeletal Medicine (2026)
Patient Profile
• Name: Tod Gouseau
, • Age: 57 years
• Sex: Male
• Occupation: Accountant (sedentary work with occasional recreational sports)
• Chief Complaint: Sudden onset of right knee pain
1. Chief Complaint
"My right knee suddenly started hurting this morning, and it’s swollen and difficult to bend."
2. History of Present Illness (HPI)
• Onset: Acute, started this morning after waking up.
• Location: Right knee, medial and anterior aspects.
• Quality: Sharp, throbbing pain.
• Severity: 7/10 on the pain scale.
• Timing: Constant, worse with movement.
• Exacerbating factors: Walking, stair climbing, bending the knee.
• Relieving factors: Rest, ice.
• Associated symptoms: Mild redness, swelling, warmth; no fever, no systemic symptoms.
• Previous episodes: None reported.
• Trauma: Denies falls, twisting injury, or sports-related trauma.
• Past medical history: Hypertension controlled with ACE inhibitor. No history of gout, diabetes, or
osteoarthritis.
• Medications: Lisinopril 10 mg daily.
• Allergies: NKDA.
• Family history: Father with osteoarthritis.
• Social history: Non-smoker, occasional alcohol, minimal exercise, BMI 30 kg/m².
3. Review of Systems (ROS)
, System Findings
Musculoskeletal Right knee pain, swelling, limited ROM
Constitutional No fever, fatigue, or weight loss
Cardiovascular No chest pain or palpitations
Respiratory No dyspnea, cough
Gastrointestinal No nausea, vomiting
Genitourinary No dysuria, hematuria
Skin Mild erythema over knee, no rash elsewhere
Neurologic No numbness, tingling, or weakness
4. Physical Examination
Vitals:
• BP: 132/80 mmHg
• HR: 78 bpm
• Temp: 36.8°C
• RR: 16/min
General: Alert, cooperative, no acute distress.
Right Knee Exam:
• Inspection: Swelling of the medial joint line, mild erythema, no ecchymosis
• Palpation: Warm, tender along medial and anterior joint line
• Range of Motion (ROM): 20–100° (limited by pain)
• Stability tests: Negative for valgus/varus stress pain; Lachman and anterior/posterior drawer
tests negative
• Effusion: Mild joint effusion, positive patellar tap
• Gait: Antalgic, favors right leg
Other Joints: No swelling, tenderness, or deformity in left knee, hips, ankles.
5. Differential Diagnosis
