[41F] With knee pain and swelling post-fall

Patient Description

A 41-year-old female presents with knee pain primarily in the front and upper part of the knee cap, which began after a fall about a week ago. The pain is sharp when weight-bearing and bending the knee, and a dull ache when at rest. The patient reports swelling and bruising directly over the knee cap, which started immediately after the fall. The swelling is somewhat hard and not warmer than the rest of the body, but it is extremely sensitive to pressure and causes a numb sensation when touched lightly. The area also appears greyish. Additionally, the patient has difficulty fully bending the knee and experiences stiffness. There is no instability, locking, clicking, or popping sounds in the knee. No fever or chills have been reported. The patient occasionally takes ibuprofen to manage the pain and swelling. Medical history includes Hodgkin's lymphoma, with no related symptoms like night sweats, unexplained weight loss, or fatigue. No known allergies and no other medications are being taken.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your knee symptoms:

  • Knee Contusion (Bruise): Given that you fell and hit your knee, it's likely that you have a contusion. This is a common injury that can cause pain, swelling, and bruising. The hard swelling and sensitivity to pressure are consistent with this diagnosis.

    • Treatment: Rest, ice, compression, and elevation (RICE) are typically recommended. Over-the-counter pain relievers like ibuprofen can help manage pain and swelling.

  • Patellar Fracture: The presence of a very defined line across the middle of your knee that is recessed could indicate a fracture of the patella (kneecap). This would explain the severe pain, swelling, and difficulty bending your knee.

    • Treatment: This requires medical evaluation. Treatment may include immobilization with a brace or cast, and in some cases, surgery may be necessary.

  • Soft Tissue Injury: The fall could have caused damage to the ligaments, tendons, or cartilage in your knee. This can lead to pain, swelling, and stiffness.

    • Treatment: Rest, ice, compression, and elevation (RICE) are recommended. Physical therapy may be needed to restore function.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take in the meantime:

  1. Rest: Avoid putting weight on your injured knee to prevent further damage.
  2. Ice: Apply ice packs to your knee for 15-20 minutes every 2-3 hours to reduce swelling and pain.
  3. Compression: Use an elastic bandage to wrap your knee, which can help control swelling.
  4. Elevation: Keep your knee elevated above the level of your heart to reduce swelling.
  5. Pain Relief: Continue taking ibuprofen as needed for pain and inflammation, following the dosage instructions.
  6. Monitor Symptoms: Use MDandMe to journal your symptoms, track your progress, and share your notes with your healthcare provider.

What you should look out for

Seek medical attention if you experience any of the following:

  • Increased Pain or Swelling: If your pain or swelling worsens despite home treatment.
  • Inability to Move Your Knee: If you cannot bend or straighten your knee at all.
  • Signs of Infection: Redness, warmth, or pus around the injury site, or if you develop a fever.
  • Instability: If your knee feels unstable or gives out when you try to stand or walk.

Remember, while I can provide guidance, it's essential to consult a healthcare professional for a formal diagnosis and appropriate treatment.

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2 mo ago

People Also Ask

What are the common symptoms of a knee contusion?

Common symptoms of a knee contusion include pain, swelling, bruising, and sensitivity to pressure. The area may also feel numb or have a dull ache when at rest.

How can I differentiate between a knee contusion and a patellar fracture?

A knee contusion typically involves bruising and swelling without a defined line across the knee. A patellar fracture may present with a sharp line or indentation across the kneecap, severe pain, and difficulty bending the knee. An X-ray is often needed to confirm a fracture.

What is the RICE method and how does it help with knee injuries?

The RICE method stands for Rest, Ice, Compression, and Elevation. It helps reduce swelling, alleviate pain, and promote healing in soft tissue injuries like knee contusions.

When should I seek medical attention for knee pain after a fall?

You should seek medical attention if your knee pain or swelling worsens, if you cannot move your knee, if there are signs of infection like redness or warmth, or if your knee feels unstable or gives out when walking.

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