Friday, August 22, 2025

Clinical problem: A middle aged man with traumatic pain in the left knee and base of the left great toe

56 years old man walking his two dogs in the morning, was suddenly taken off guard when the dogs got excited after spotting a herd of pigs and pulled free from the leash toppling the man in the process. As soon as he fell he suffered from excruciating pain in left knee and base of left great toe and barely managed to walk home limping with pain.


On examining of the knee and toe in the evening:



Radiology of the foot:




Day 2 morning:



Day 2 evening:




Objective examination and interpretation: Swelling persists due to traumatic inflammation. 

Confirmed on palpation with no palpable fracture dislocation

Subjectively as related by the patient and interpreted by physician:

The pain exacerbates on prolonged sitting and produces marked stiffness in surrounding muscles which reduces slowly on prolonged walking suggestive of ligamental inflammation or enthesitis


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