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A 62-year-old man with 3-month history of progressive right knee pain

Orthopedics Today, June 2017
CPT Sally A. Corey, DO; John Bunyasaranand; MAJ William F. Scully, MD; MAJ Jacob C. Rumley, DO; Craig D. Cameron, DO

A 62-year-old African-American man who presented to the orthopedic clinic reported he had a 3-month history of atraumatic, progressive right knee pain. He said he did not have any prior injuries or surgeries. He is a life-long, one pack-per-day smoker with no other pertinent medical history. On exam, a mild knee effusion was present and knee range of motion was 0° to 130°. The patient had pain at the extremes of his knee motion. Otherwise, the patient had a normal lower extremity exam. Digital clubbing was identified (Figure 1a), as were diffuse pruritic skin plaques (Figure 1b).

The imaging obtained included radiographs of the right knee (Figures 2a and 2b) and right femur (Figure 3), a whole-body bone scan (Figure 4) and MRI (Figures 5a and 5b) of the right knee.

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