BACKGROUND
An otherwise healthy 56-year-old woman presents to the clinic with complaints of progressive knee pain and loss of range of motion (ROM). The symptoms have not improved since they began 2 years ago, and they worsen with activity. Further questioning reveals that the woman noticed "lumps in the back of her knee," which made her seek medical attention. She resides in a remote region, and her past medical history is unremarkable.
On physical examination, the patient has an antalgic gait and a moderately effused right knee with limited active and passive knee flexion and extension. No ligament laxity is observed, and meniscal testing produces pain. Palpation of the knee reveals some mild joint line tenderness and multiple hard, mobile nodules in the popliteal fossa. All other joints are unaffected.
Radiographic examination shows mild-to-moderate arthritic changes of the medial compartment, with multiple loose bodies throughout the joint. What is the diagnosis?
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Hint
The synovium of the joint is implicated in the disease process.
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Author:
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Raul A. Kuchinad, BSc, MSc, Queen's University, School of Medicine, and John Birchard, MD, Assistant Professor, Department of Surgery, Queen's University, Ontario, Canada
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Queen's University, Kingston, Ontario, Canada
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eMedicine Editor:
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Sat Sharma, MD
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Associate Professor, University of Manitoba, Department of Medicine, Division of Pulmonary Medicine
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eMedicine Case
