Differential Diagnosis for 62-year-old Female with Knee Pain
- Single most likely diagnosis
- Meniscal Tear: The patient's symptoms of intermittent lateral knee pain that worsened with a specific incident (bending down) and is exacerbated by weightbearing and touch, suggest a meniscal tear. The sharp stabbing pain and radiation into the knee and lateral shin also support this diagnosis.
- Other Likely diagnoses
- Ligament Sprain: The mechanism of injury (bending down) and the location of the pain (lateral knee) could also suggest a ligament sprain, particularly of the lateral collateral ligament.
- Osteoarthritis: Given the patient's history of arthritis, osteoarthritis of the knee could be contributing to her symptoms, especially with weightbearing activities.
- Tendinitis: The patient's symptoms could also be consistent with tendinitis, such as iliotibial (IT) band tendinitis, which is common in runners but can also occur in non-athletes.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Deep Vein Thrombosis (DVT): Although the patient's symptoms do not strongly suggest DVT, her history of a previous blood clot and the acute onset of pain warrant consideration of this diagnosis. DVT can be deadly if missed and not treated promptly.
- Osteonecrosis: This condition, also known as avascular necrosis, can cause knee pain and is more common in patients with a history of arthritis or previous trauma.
- Infection (Septic Arthritis): Although less likely, infection should always be considered in the differential diagnosis of acute knee pain, especially if there is any suspicion of trauma or recent surgery.
- Rare diagnoses
- Tumor: A tumor, such as an osteosarcoma or a soft tissue sarcoma, could cause knee pain, although this would be a rare cause of the patient's symptoms.
- Complex Regional Pain Syndrome (CRPS): This condition is characterized by chronic pain, swelling, and limited range of motion, but it is relatively rare and would be an unlikely diagnosis without other supporting symptoms.