A 72-year-old male presents with a 3-month history of anterior knee pain, particularly during activities like climbing stairs or sitting for prolonged periods. He denies any history of trauma and has a history of diabetes. Physical Exam Findings: General: Slightly overweight male Inspection: No visible swelling or deformity Palpation: Tenderness around the patella Special Tests: Positive patellar compression test, no instability MCQs: What is the most likely diagnosis for this patient? A) Patellofemoral pain syndrome B) Osteoarthritis C) Iliotibial band syndrome D) Bursitis Which pharmacological management option is appropriate for this patient? A) Oral corticosteroids B) Topical NSAIDs C) Opioids D) DMARDs What would be an appropriate indication for referral to orthopedics in this case? A) Persistent symptoms despite a trial of conservative management B) Patient's age C) Diagnosis of diabetes D) Presence of mild swelling Answers with Explanations: Answer: A) Patellofemoral pain syndrome Explanation: The patient's symptoms are consistent with patellofemoral pain syndrome, common in elderly individuals, especially with certain activities. Answer: B) Topical NSAIDs Explanation: Topical NSAIDs can provide localized pain relief with fewer systemic side effects, making them suitable for this patient. Answer: A) Persistent symptoms despite a trial of conservative management Explanation: Referral to orthopedics is appropriate if symptoms do not improve with conservative treatment. Overview of the Topic: Patellofemoral Pain Syndrome in Elderly Patients Patellofemoral pain syndrome is a common cause of knee pain in the elderly. Management involves both non-pharmacological and pharmacological approaches, focusing on alleviating pain and improving function. Key Learning Points: Early intervention and education about activity modification can significantly benefit outcomes. Referral to orthopedics may be needed for persistent cases.
