- Knee pain?
Why: If have knee swelling without pain, especially on motion, would suggest Charcot's disease (degenerative joint disease due to lack of protective pain sensation. May be associated with neurosyphilis, cauda equina lesion, diabetic neuropathy or syringomyelia).
- Knee locking (sudden inability to extend the knee fully but ability to flex fully)?
Why: suggests torn meniscus, loose body, torn anterior cruciate ligament, avulsed anterior tibial spine, dislocated patella.
- Knee catching (feel that something is getting in the way of joint movement but not locking)?
Why: suggests subluxing patella, loose bodies, torn meniscus, torn anterior cruciate ligament, avulsed anterior tibial spine, dislocated patella.
- Knee crepitus (knee grating with movement)?
- Prominent systemic symptoms?
Why: (e.g. weight loss, fever, malaise) - should consider Reiter's disease, systemic lupus erythematosus, Rheumatoid arthritis and rheumatic fever.
- Fever?
Why: may suggest septic arthritis, rheumatic fever, Reiter's syndrome, Lyme arthritis, systemic lupus erythematosus, Still's disease, rheumatoid arthritis and osteomyelitis.
- Urethral discharge?
Why: would suggest Reiter's syndrome or gonococcal arthritis.
- Recent diarrhea?
Why: may suggest enteropathic arthritis (such as due to Ulcerative colitis or Crohn's disease) or Reiter's syndrome.
- Skin rash?
Why: may suggest psoriatic arthritis.
- Eye pain?
Why: may suggest Reiter's disease.
- Symptoms of Osteoarthritis?
Why: e.g. usually symmetrical and can affect many joints. Pain is worse at the end of the day and aggravated by use and cold weather, relieved by rest. Usually associated with pronounced stiffness, especially after activity.
- Symptoms of Rheumatoid arthritis?
Why: e.g. usually starts with the gradual onset of pain and stiffness of the small joints of the hands and feet. May also affect the wrist, ankles, knees, shoulder, neck and jaw. Joint pain is worse on waking, nocturnal pain with disturbed sleep, pain is relieved with activity. Morning and rest stiffness can last for hours. May be associated with weakness, weight loss, malaise and fatigue.
- Symptoms of gout?
Why: e.g. often excruciating pain in the great toe starting in the early hours of the morning, skin over the joint may be red, shiny, swollen and hot, joint is very tender to touch. May also affect knees, ankles and fingers. Pain may be precipitated by alcohol excess, surgical operation, starvation and certain medications.
- Symptoms of Rheumatic fever?
Why: e.g. typically occurs in children and young adults, migratory polyarthritis (many joints are involved, joints affected alter with time), involves large joints sequentially, one becoming hot, red, swollen and very painful as the other subsides. It rarely lasts more than five days in any one joint. Associated with acute fever.
- Symptoms of Reiter's syndrome?
Why: e.g. conjunctivitis, urethritis (painful urination, penile discharge, vaginal discharge). The arthritis tends to affect the larger peripheral joints especially the ankle and knees.
- Symptoms of Crohn's disease, Ulcerative Colitis or gastroenteritis?
- Symptoms of Lyme disease?
Why: e.g. months or years after a tick bite develop joint pain, usually of the large joints such as knee; typical rash (a dough-nut shaped red rash about 6cm in diameter) at the bite site; heart disorders (especially abnormal rhythms of the heart) or disease of the central nervous system (including weakness of the muscles in the limbs, muscular pain or evidence of meningitis).
- Symptoms of Osgood-Schlatter's disorder?
Why: e.g. occurs in children aged 10-14 commonly in those involved in sports involving running, kicking and jumping. Localised pain in region of the tibial tubercle (bony protuberance at front of knee below knee cap) during and after activity, aggravated by kneeling down and going down stairs. Associated with the development of a lump and tenderness in the area.
- Symptoms of meniscal tears?
Why: e.g. Often caused when there is history of injury with twisting movement with the foot firmly fixed on the ground. Present with pain over the joint line, locking of the knee, swelling of the knee and pain worse with activity.
- Symptoms of anterior cruciate ligament tear?
Why: e.g. onset of pain after a sporting injury such as landing from a jump or a forced rotational strain of the knee when another player falls across the knee. Results in immediate swelling of the knee due to accumulation of blood in the knee joint. Problems after the injury of knee pain and knee "giving way".
- Symptoms of medial collateral ligament rupture?
Why: e.g. often caused by a direct force to the outer side of the knee. Causes pain and localized swelling on the inner side of the knee which is aggravated by twisting of the knee.
- Symptoms of septic arthritis of the knee?
Why: e.g. intense joint pain, feeling unwell, fever. The joint is usually held rigid.
