Family Medicine: Knee Pain

This morning we had some residents from Plaza talk to us about knee pain, specifically patellofemoral syndrome, and how it should be diagnosed and treated before jumping the gun and heading to the orthopedic surgeon for an arthroscope. "Check the kneecaps and see if they're level," he said. "If the quads are tight, then one side will be higher than the other." Then after class, Deanna became a guinea pig for his talk; she'd hurt her leg skiing a while back and has trouble climbing stairs. Indeed, one kneecap was higher than the other, and after doing some muscle energy to stretch the quads, the kneecaps became more level. "See, good case study," said the resident, who seemed pleased that he was able to show how his lecture applies to real patients.

Afterwards it was back to the clinic. My topic to study last night was ear pain, so when we had a spare moment I talked to Dr. RR about otitis media, otitis externa, and chronic otitis media. I'm actually glad that Dr. RR gives me assignments to read and look up in my spare time; otherwise, I'd just go home and do nothing. Tomorrow's topic: hypertensive drugs *Goes to find drug charts* We saw slightly more adults than children today. Once again, colds and allergies were running rampant throughout the clinic, but I got one little girl with a temperature of 105. She was really sick; her heart rate was probably about 140 and she didn't want to move at all. The nurse gave her some Motrin in the room; her temp started falling after a while so then she was free to go. The last patient came for "shooting pain down her leg" that turned out to be just hamstring tightness, but Dr. RR sent me out of the room b/c she was also depressed and he wanted to ask her how she was doing on her meds. Later he said he probably shouldn't have sent me to see her, but it wasn't too bad. One interesting factoid that was thrown out was that 85% of patients are non-compliant. Great...