Musculoskeletal Disorders
A 68 yo male comes to the ER with severe right knee pain. he reports it stated about 8 hours ago and woke him up out of a deep sleep at 0200. He reports the pain was so severe he could not tolerate the sheets touching him. On exam you note the knee to now be erythematous, swollen and warm, both above and below the knee are WNL. Patient’s temp is 99.4 and HR 114, RR 20, BP 152/88. Patient does report a mild history of gout, but he has controlled it with dietary changes and without medications. He reports no other medical history, but does tell you he “is not one for going to the doctor either.” As the AGACNP on call, you are now working up the patient for admission.
Discussion should address the following:
Give at least three differential diagnoses: Gout, Septic Arthritis, Bursitis
What is the most likely diagnosis
What is your Treatment plan for the patient
What is your rationale for your selected treatment options?
