Cyrus Horton Case Study: Acute Knee Pain Evaluation and Management, Exams of Nursing

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• I HUMAN CYRUS HORTON CASE STUDY

YEAR OLD WITH ACUTE LEFT KNEE PAIN FOR 2

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iHuman Case Study: Cyrus Horton

Cyrus Horton is a 57-year-old male who presents with acute pain in his left knee that started 2 days ago. The pain began suddenly while he was climbing stairs and has been persistent since. The pain is described as sharp and severe, with a rating of 8 out of 10 on the pain scale. It is localized to the medial aspect of the knee and is aggravated by weightbearing and movement. Resting provides some relief, but the pain remains constant. There is noticeable swelling and stiffness in the knee, and he has difficulty bending and straightening it. Additional Symptoms:

• Type 2 Diabetes Mellitus (controlled with diet and medication)
• Osteoarthritis in the hands and lower back Surgical History
• Appendectomy at age 22
• Right knee arthroscopy 5 years ago for a meniscal tear

Medications

Family History

• Father: Deceased at 75 (Myocardial Infarction)
• Mother: Alive at 80 (Hypertension, Osteoarthritis)

• Siblings: Brother with Type 2 Diabetes Social History
• Occupation: Accountant
• Lives with wife; two adult children Smokes 1 pack of cigarettes per day for 30 years Drinks alcohol occasionally (1- 2 drinks per week)

• Respiratory: Denies cough, wheezing, shortness of breath.

• Gastrointestinal: Denies nausea, vomiting, abdominal pain, changes in bowel habits.

• Genitourinary: Denies dysuria, hematuria, urinary frequency.

• Musculoskeletal: Reports pain and swelling in the left knee; denies pain in other joints. Neurological: Denies headaches, dizziness, weakness, numbness.

• Dermatological: Denies rashes, lesions. Physical Examination General

• Alert and oriented; appears in mild distress due to pain. Vital Signs

• Blood Pressure: 130/80 mmHg

Musculoskeletal Examination

• Inspection:
• Left knee shows mild swelling; no erythema or warmth.
• No deformities or visible bruising.
• Palpation:
• Tenderness over the medial joint line of the left knee.
• No palpable effusion or crepitus.
• Range of Motion:

• Limited due to pain: flexion to 90 degrees, extension to
  • 10 degrees.
• Pain worsens with passive and active movement.
• Special Tests:
• Positive McMurray test indicating possible meniscal tear.
• Negative Lachman test and anterior drawer test (no signs of ACL injury).
• Negative varus and valgus stress tests (no signs of collateral ligament injury). Other Systemic Examinations

1. Meniscal Tear
2. Osteoarthritis Exacerbation
3. Gout
4. Septic Arthritis
5. Bursitis
6. Ligament Injury Diagnostic Testing Imaging

• X-ray of the Left Knee: To evaluate for fractures, osteoarthritis, and any acute bony changes.
• MRI of the Left Knee: For detailed evaluation of soft tissue structures, including menisci, ligaments, and cartilage. Laboratory Tests
• Complete Blood Count (CBC): To check for infection or inflammation.