What is the diagnosis for a 30-year-old male patient complaining of knee pain, with a negative X-ray result?

SOAPE Note

• S: 30-year-old male patient complaining of knee pain.
• O: X-ray is negative.
• A: The differential diagnosis for knee pain in a 30-year-old male with a negative x-ray can be categorized as follows:
  • Single Most Likely Diagnosis
    • Ligament Sprain: This is a common injury in young adults, especially if the patient has a history of sports or physical activity. The negative x-ray supports this diagnosis, as ligament sprains do not show up on x-ray.
  • Other Likely Diagnoses
    • Meniscal Tear: A meniscal tear is a possible cause of knee pain, especially if the patient has a history of twisting or bending injuries. An MRI would be needed to confirm this diagnosis.
    • Tendinitis: Tendinitis, such as patellar tendinitis, is a common cause of knee pain in young adults, especially if they are involved in sports or activities that involve jumping or running.
    • Bursitis: Bursitis, such as prepatellar bursitis, can cause knee pain and swelling, especially if the patient has a history of kneeling or direct trauma to the knee.
  • Do Not Miss Diagnoses
    • Septic Arthritis: Although less likely, septic arthritis is a serious and potentially life-threatening condition that requires prompt diagnosis and treatment. Risk factors include recent trauma, immunocompromised state, or history of intravenous drug use.
    • Osteonecrosis: Osteonecrosis, also known as avascular necrosis, is a rare but serious condition that can cause knee pain and requires prompt diagnosis and treatment.
  • Rare Diagnoses
    • Osgood-Schlatter Disease: This is a rare condition that causes knee pain and swelling in adolescents and young adults, especially if they are involved in sports or activities that involve running or jumping.
    • Sinding-Larsen-Johansson Syndrome: This is a rare condition that causes knee pain and swelling in adolescents and young adults, especially if they are involved in sports or activities that involve running or jumping.
• P: Further evaluation and treatment will depend on the suspected diagnosis. This may include ordering an MRI to evaluate for meniscal tears or tendinitis, or ordering blood work to evaluate for septic arthritis or osteonecrosis. The patient may also be referred to an orthopedic specialist for further evaluation and treatment.
• E: The patient will be scheduled for follow-up in one week to re-evaluate their symptoms and adjust their treatment plan as needed.