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Differential Diagnosis for a 70-year-old Female with Acute Knee Swelling and Pain

Single Most Likely Diagnosis

  • Crystal Arthropathy (Gout or Pseudogout): This is a common condition in the elderly, characterized by sudden onset of joint pain and swelling, often without a clear precipitating injury. The symptoms can resolve on their own within 24 hours, which fits the patient's presentation.

Other Likely Diagnoses

  • Meniscal Tear or Ligament Sprain: Although the patient reported no injury, minor trauma can sometimes be forgotten or not recognized as significant. These conditions can cause knee pain and swelling.
  • Bursitis: Inflammation of the bursae around the knee can cause pain and swelling, and can occur without a specific injury.
  • Overuse or Degenerative Joint Disease: Osteoarthritis or overuse of the knee joint can lead to pain and swelling, especially in older adults.

Do Not Miss Diagnoses

  • Septic Arthritis: Although less likely, this is a medical emergency that requires prompt diagnosis and treatment. Bacterial infection of the joint can cause rapid onset of pain, swelling, and decreased range of motion.
  • Deep Vein Thrombosis (DVT): DVT can cause swelling and pain in the leg, and although it's more commonly associated with the calf, it should be considered, especially in older adults.
  • Osteonecrosis: Avascular necrosis of the bone can cause sudden onset of knee pain, especially if it involves the femoral condyle.

Rare Diagnoses

  • Hemarthrosis: Bleeding into the joint space, which could be due to a bleeding disorder, anticoagulant use, or a vascular malformation.
  • Neoplastic Processes: Tumors, either primary or metastatic, can cause joint pain and swelling, although this would be less common and might be accompanied by other systemic symptoms.
  • Inflammatory Arthritis (e.g., Rheumatoid Arthritis, Lupus): These conditions can cause joint pain and swelling but typically involve multiple joints and are accompanied by other systemic symptoms.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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