ENCOUNTER KNEE PAIN | LOCATION 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
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)
Relevance to
Differential Rationale / Typical Features
Case
Gradual onset, age > 60 yrs, joint-
Osteoarthritis (OA) Highly likely
space loss, stiffness < 30 min
Rheumatoid Bilateral symmetric joints, systemic Unlikely (mono-
Arthritis (RA) features articular)
Sudden severe pain, erythema, Unlikely (chronic
Gout / Pseudogout
warmth course)
Septic Arthritis Fever, redness, elevated WBC No infection signs
Osteoporotic
Acute pain after trauma No injury
Fracture
Possible but less
Bursitis / Tendinitis Local tenderness without stiffness
likely
Most Likely Diagnosis: Primary Osteoarthritis of the Right Knee (M17.11)