Hello Listserve,
I just saw a 19 year old Caucasian male who is 6′, 179 pounds. He began having widespread joint pain in August 2014; he began depending on a single point cane in January 2015. The physicians have different ideas of what his diagnosis is, from Marfan’s to Rheumatoid Arthritis. He will see a rheumatologist for further evaluation later this month.
A physician sent him to me for a knee orthosis due to knee pain. When he walks now, he keeps the leg locked as it can buckle (although keeping it locked does not get rid of the pain). His main issue is pain in the knee (also ankle, and shoulder, and…). There is intermittent swelling around the patella; the knee pain is centered behind the patella. He describes the pain as sharp, stabbing; it happens all day, with any position, any activity or non-activity. No reported dislocations.
There is no discoloration, no history of surgery or trauma; imaging came back negative for any abnormalities. Examination shows no deformity; quads 4/5, 4+/5 hamstrings.
I feel clueless on this one; any thoughts on knee orthosis types to use that might benefit him? Patellar tracking does not appear to be an issue.
Thanks in advance for the advice!!
Gretchen Wellman CO
Northern Orthopedics, Inc.
