Author: Claire Gross, MD
Co Author #1: Christopher Hogrefe, MD
Patient Presentation:
50 year old male with left median knee pain and swelling.
History:
50 year old active male with history of gastroesophageal reflux and hyperlipidemia presented to our Sports Medicine Clinic for evaluation of left medial knee pain and swelling of nine months duration. He denied preceding trauma, erythema, ecchymosis, numbness, weakness, clicking, locking, or instability. He was evaluated at another facility and underwent aspiration of the area twice without improvement. In the 1990s he had similar symptoms and underwent an open excision and debridement of the area which resolved his symptoms until nine months ago. He denied shortness of breath, chest pain, other joint pain or swelling, back pain, or rashes.
Physical Exam:
Visual inspection revealed a bulbous fluid collection along the medial aspect of the left knee, overlying the medial joint line and extending distally over the proximal tibia. The area was boggy without fluctuance. There was no erythema, ecchymosis, or effusion. It was minimally tender to palpation, with no other areas of tenderness. He had full, painless flexion and extension. Resisted range of motion was non-painful. Strength was 5/5, and sensation was intact in the lower extremities. Special tests, including ligamentous and meniscal testing, were negative. The patient's gait was unremarkable.
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