Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a chronic, progressive history of right knee pain, localized swelling, and restricted range of motion. Symptoms are associated with constitutional signs including low-grade evening fevers, night sweats, and unintentional weight loss. No history of recent trauma. Patient reports morning stiffness and progressive antalgic gait.
Clinical Examination Findings
Right knee examination reveals fusiform swelling, synovial thickening, and localized warmth without erythema. Tenderness noted along the joint line. Range of motion is significantly limited by pain and muscle spasm. Atrophy of the quadriceps muscle is evident. Distal neurovascular status is intact. No palpable popliteal lymphadenopathy.
Treatment Protocol
Initiate multi-drug antitubercular chemotherapy (RIPE regimen: Rifampin, Isoniazid, Pyrazinamide, Ethambutol) for the prescribed duration. Immobilization of the right knee via splinting or bracing to prevent deformity. Monitor liver function tests and visual acuity periodically. Surgical consultation for potential synovial biopsy, debridement, or joint stabilization if indicated.