History

HPI

Knee pain context

OPQRST

Onset

Provocation and palliation

Quality

Region and radiation

Severity

Timing

Associated symptoms

Local symptoms

Systemic symptoms

Neurovascular symptoms

Prior episodes and baseline

Baseline function

Prior similar episodes

Alarm Features

Immediate threats

Limb and life threats

Vital sign danger thresholds

High risk vitals

Escalation triggers

Immediate escalation

Medications

Current and recent medications

Medication exposure relevant to knee pain

Analgesic history

Pain treatment already tried

Contraindications to common therapies

NSAID risk

Acetaminophen risk

Diet

Hydration and exposures

Intake pattern

Alcohol exposure

Purine related pattern

Review of Systems

Musculoskeletal

Joint pattern

Other joint symptoms

Infectious and inflammatory

Infection symptoms

Inflammatory clues

Cardiopulmonary and thromboembolic

Thrombosis symptoms

Collateral History and Family History

Collateral and reliability

Source

Reliability factors

Family history

Heritable and early disease

Risk Factors

Infection risk

Septic arthritis risks

Trauma and overuse risk

Mechanical risks

Thrombosis and bleeding risk

DVT risks

Hemarthrosis risks

Differential Diagnosis

Life threatening

Cannot miss

Common

High prevalence

Less common

Lower prevalence and mimics

Past Medical History

Relevant conditions

Chronic disease and relevance

Surgeries and devices

Prior procedures

Baseline function and supports

Functional baseline

Social supports

Physical Exam

General and vitals

Global assessment

Gait and function

Knee inspection and palpation

Local findings

Range of motion

Motion pattern

Ligament exam

Stability tests

Meniscus and patellofemoral

Mechanical tests

Patellar tracking and pain

Extensor mechanism

Quadriceps and patellar tendon integrity

Neurovascular and adjacent joints

Distal perfusion and nerves

Hip and ankle screen

Special populations pitfalls

High risk groups

Lab Studies

Core labs when infection or systemic illness

Infection evaluation

Arthrocentesis studies for effusion with concern for infection or crystals

Synovial fluid panel

Coagulation and bleeding evaluation

Hemarthrosis risk

Metabolic and medication safety

Analgesic safety checks

Imaging

Scoring Systems

Knee radiography decision tools

MRI

MRI knee use cases

CT

CT knee use cases

Ultrasound

Ultrasound applications

Special Tests

Bedside maneuvers and procedures

Targeted diagnostics

Procedural imaging adjuncts

Guidance tools

ECG

When ECG is relevant in knee pain presentations

Fall or collapse context

High risk comorbidity context

Assessment

Problem framing

Knee pain syndrome classification

Severity and risk stratification

High risk features

Complications to exclude

Plan

First 5 minutes for critical presentations

Immediate workflow

Analgesia and symptom control

Multimodal pain plan

Diagnostic sequencing

Pathway driven testing

Infection management

Suspected septic arthritis

Immobilization and mobility

Function protection

Reassessment loop

Timed reassessment

Disposition

ICU and high acuity triggers

ICU or resuscitation level care

Inpatient admission indications

Admit criteria

Observation pathway

Observation appropriate

Discharge criteria and follow up

Discharge appropriate

Follow up timing

Discharge Instructions

Copy discharge instructions

Knee pain discharge summary

Medications

Activity

Follow up

Return to the emergency department now for

References

Core guidelines and decision tools

Evidence base