Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with progressive, localized pain in the left knee, specifically localized to the medial joint line. Pain is exacerbated by weight-bearing and activity, with nocturnal symptoms reported. No history of acute trauma. Symptoms are consistent with spontaneous osteonecrosis of the knee (SONK).
Clinical Examination Findings
Left knee examination reveals focal tenderness to palpation over the medial femoral condyle. Mild-to-moderate joint effusion present. Range of motion is limited by pain, particularly during terminal extension and deep flexion. No ligamentous instability noted. Gait is antalgic, favoring the left lower extremity.
Treatment Protocol
Conservative management initiated: strict non-weight-bearing or partial weight-bearing with crutches, activity modification, and NSAIDs for pain control. Referral for MRI to stage the lesion. Discussion regarding potential surgical intervention (core decompression, osteochondral grafting, or arthroplasty) pending imaging results.