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)
Patient Profile
• Name: Tod Gouseau
, • Age: 57 years
• Sex: Male
• Occupation: Office worker
• Height/Weight: 5'10", 200 lbs (BMI ~28.7, overweight)
• Chief Complaint: “My right knee started hurting suddenly yesterday.”
• Date of Visit: January 16, 2026
History of Present Illness (HPI)
Tod Gouseau is a 57-year-old male presenting with acute onset right knee pain that began yesterday
after playing recreational tennis. He reports:
• Pain characteristics: Sharp, localized to the medial aspect of the knee; pain score 7/10 at worst.
• Onset: Sudden, after a pivoting motion on the tennis court.
• Aggravating factors: Walking, climbing stairs, twisting the knee.
• Relieving factors: Rest, ice, over-the-counter acetaminophen (minimal relief).
• Associated symptoms: Mild swelling, no redness or warmth. Denies fever, locking, or giving-way
episodes.
• Past history: Occasional knee stiffness, no prior major injuries.
• Medications: Occasional ibuprofen for headaches.
• Allergies: None reported.
• Social history: Non-smoker, drinks socially, no recreational drugs.
Review of Systems (ROS)
• Musculoskeletal: Positive for right knee pain and stiffness. No pain in other joints.
• Constitutional: Denies fever, fatigue, or weight loss.
• Neurologic: Denies numbness or tingling in the leg.
• Vascular: Denies calf pain or swelling suggestive of DVT.
• Other systems: Negative.
Physical Examination
, Vital Signs:
• BP: 132/78 mmHg
• HR: 78 bpm
• RR: 16/min
• Temp: 36.8°C
Inspection:
• Mild effusion of the right knee
• No erythema or bruising
Palpation:
• Tender over medial joint line
• No warmth
• No bony deformity
Range of Motion (ROM):
• Flexion: 0–120° (pain at terminal flexion)
• Extension: 0° (full)
Special Tests:
• McMurray test: Positive for medial meniscus pain
• Lachman test: Negative
• Anterior/Posterior drawer tests: Negative
• Valgus stress test: Mild pain
• Varus stress test: Negative
• Patellar grind: Negative
Gait:
• Mild antalgic gait favoring the right leg
Differential Diagnosis
Musculoskeletal Medicine: Acute Knee Pain
Presentation—Patient: Tod Gouseau—with
Diagnostic Reasoning, Evidence-Based
Treatment, and Follow-Up Planning (2026)
Patient Profile
• Name: Tod Gouseau
, • Age: 57 years
• Sex: Male
• Occupation: Office worker
• Height/Weight: 5'10", 200 lbs (BMI ~28.7, overweight)
• Chief Complaint: “My right knee started hurting suddenly yesterday.”
• Date of Visit: January 16, 2026
History of Present Illness (HPI)
Tod Gouseau is a 57-year-old male presenting with acute onset right knee pain that began yesterday
after playing recreational tennis. He reports:
• Pain characteristics: Sharp, localized to the medial aspect of the knee; pain score 7/10 at worst.
• Onset: Sudden, after a pivoting motion on the tennis court.
• Aggravating factors: Walking, climbing stairs, twisting the knee.
• Relieving factors: Rest, ice, over-the-counter acetaminophen (minimal relief).
• Associated symptoms: Mild swelling, no redness or warmth. Denies fever, locking, or giving-way
episodes.
• Past history: Occasional knee stiffness, no prior major injuries.
• Medications: Occasional ibuprofen for headaches.
• Allergies: None reported.
• Social history: Non-smoker, drinks socially, no recreational drugs.
Review of Systems (ROS)
• Musculoskeletal: Positive for right knee pain and stiffness. No pain in other joints.
• Constitutional: Denies fever, fatigue, or weight loss.
• Neurologic: Denies numbness or tingling in the leg.
• Vascular: Denies calf pain or swelling suggestive of DVT.
• Other systems: Negative.
Physical Examination
, Vital Signs:
• BP: 132/78 mmHg
• HR: 78 bpm
• RR: 16/min
• Temp: 36.8°C
Inspection:
• Mild effusion of the right knee
• No erythema or bruising
Palpation:
• Tender over medial joint line
• No warmth
• No bony deformity
Range of Motion (ROM):
• Flexion: 0–120° (pain at terminal flexion)
• Extension: 0° (full)
Special Tests:
• McMurray test: Positive for medial meniscus pain
• Lachman test: Negative
• Anterior/Posterior drawer tests: Negative
• Valgus stress test: Mild pain
• Varus stress test: Negative
• Patellar grind: Negative
Gait:
• Mild antalgic gait favoring the right leg
Differential Diagnosis
