Differential Diagnosis for Medial Knee Pain in a 75-year-old Female
- The patient's symptoms and physical examination findings suggest a condition affecting the medial aspect of the knee, which is exacerbated by activities such as stair climbing.
Single most likely diagnosis
- Medial Meniscual Tear: This is the most likely diagnosis given the patient's age, symptoms, and physical examination findings. The menisci are cartilaginous structures in the knee joint that can tear due to degenerative changes or trauma, leading to pain, swelling, and tenderness, especially with activities that involve twisting or bending of the knee.
Other Likely diagnoses
- Medial Compartment Osteoarthritis: This condition involves wear and tear of the cartilage in the medial compartment of the knee, leading to pain, stiffness, and swelling. The patient's age and symptoms, such as worsening pain with stair climbing, are consistent with this diagnosis.
- Pesparing Osteonecrosis: This condition involves the death of bone tissue due to a lack of blood supply, which can occur in the medial femboing or tibial condyles. It can cause pain and tenderness in the affected area, especially with weight-bearing activities.
- Medial Tibial Stress Syndrome: This condition, also known as shin splints, involves pain and inflammation in the medial aspect of the tibia, often due to overuse or repetitive stress. However, it is less common in older adults.
Do Not Miss diagnoses
- Tumor or Cyst: Although rare, a tumor or cyst in the medial aspect of the knee, such as a meniscal tear with an associated cyst, can cause similar symptoms and must be considered to avoid delayed diagnosis.
- Infection or Septic Arthritis: Infection in the knee joint can cause severe pain, swelling, and tenderness, and can be life-threatening if not promptly treated.
- Deep Vein Thrombosis: This condition involves a blood clot in the deep veins of the leg and can cause pain, swelling, and tenderness in the affected area, although it is more common in the calf than in the knee.
Rare diagnoses
- Osgood-Schlatter Disease: This condition involves inflammation of the tibial tubercle, where the patellar tendon attaches to the tibia, and is more common in adolescents.
- Sinding-Larsen-Johansson Syndrome: This condition involves inflammation of the proximal patellar tendon and is also more common in adolescents.
- Medial Pining Syndrome: This condition involves compression of the saphenous nerve, which runs along the medial aspect of the knee, and can cause pain, numbness, and tingling in the affected area.