Respond to at your colleagues. Analyze the possible conditions from your colleagues' differential diagnoses. Determine which of the conditions you would reject and why. Identify the most likely condition, and justify your reasoning.
Review of Case Study #3
Patient Information:
Name: MR Age: 15 Sex: Male Race: Caucasian
SUBJECTIVE.
CC: Dull pain in both Knees
HPI: MR, is a 15-year-old Caucasian male who presents with complaints of dull pain in both knees. He states that sometimes one or both knees click, and he describes a catching sensation under the patella.
Additional history to determine the cause of the knee pain:
Can you point or touch area where you feel the pain? Is it anterior, posterior, medial or lateral?
What is the onset of the knee pain? Was it sudden or gradual?
Can you describe the pain? Are there any activities that alleviate the pain? Is the pain intermittent or constant?
What makes the pain worse? Is it worse after being still for an extended period or with activity?
Is the pain worse at a certain time?
What makes it better or worse? Have you tried any home remedies or medications, heat, ice, or therapy?
What would you rate your pain on a scale of 1-10?
Current Medications: None
Allergies: NKDA
PMHx: None
Soc Hx: Assess MR’s daily activities, Is he in school, what grade? Does he participate in any sports, any repetitive motions with the joints? is he active or sedentary? Any recent weight change, has he had a growth spurt? Assess his nutrition status.
Fam Hx: assess for family history of any diseases.
ROS:
GENERAL: Assess for unintentional weight loss or gain, fever, chills, fatigue.
HEENT: No problems reported.
SKIN: No itching, rash or redness.
CARDIOVASCULAR: No chest pain, chest pressure or chest discomfort. Negative for palpitations or edema.
RESPIRATORY: No shortness of breath or cough, no history asthma.
GASTROINTESTINAL: No abdominal pain, change in appetite, nausea or vomiting. No constipation or diarrhea.
GENITOURINARY: No difficulty or pain with urination.
NEUROLOGICAL: No syncope, headache, paralysis, numbness or tingling.
MUSCULOSKELETAL: Assess for joint pain or stiffness, swelling redness, or warmth.
HEMATOLOGIC: Assess for any unusual bleeding or bruising.
LYMPHATICS: N/A
PSYCHIATRIC: Assess for stress, anxiety, or depression.
ENDOCRINOLOGIC: Assess for increased thirst or urination, cold or hot intolerance, abnormal patterns of hair growth.
ALLERGIES: No known allergies.
OBJECTIVE.
Physical exam: deferred
Height, weight and Vital signs should be obtained, and growth to be assessed on the growth chart. Assess general constitutional and examine findings of the body systems pertinent to the chief complaint and history of the patient’s present illness (Dains, Baumann & Scheibel, 2016). The health care provider should observe the patient’s gait to assess for a limp (Dains et al., 2016). Palpation of the affected joint will enable the health care provider to assess for crepitus, warmth or tenderness while checking muscle tone; inspect and palpate the knees and the popliteal space while flexed and extended (Ball, Dains, Flynn, Solomon & Stewart, 2015). Assessment of active and passive range of motion should also be done.
Sample Solution