++
“My right knee hurts really bad.”
++
History of Present Illness
++
AD is a 66-year-old female who had a right total knee arthroplasty (TKA) and has been experiencing right knee pain that has increased gradually in severity since 2 weeks ago. The pain is persistent and moderate to severe. She also has been having trouble walking around the block. Of note, the right knee is swollen and red. She followed up in clinic with her surgeon yesterday and was told she needed to be admitted to the hospital.
++
Obesity, type 2 diabetes, osteoarthritis, hypertension, hyperlipidemia, depression
++
Right TKA 3 weeks ago, C-section
++
Father died at age 62 from a heart attack; mother died at age 70 from breast cancer
++
No alcohol, tobacco, or IV drug use; lives at home with her husband; she is retired
++
++
++
Desvenlafaxine 50 mg PO daily
++
Ibuprofen 600 mg PO TID PRN
++
Lisinopril 40 mg PO daily
++
Hydrochlorothiazide 25 mg PO daily
++
Simvastatin 80 mg PO daily
++
Temp 100°F, P 78, RR 16 breaths per minute, BP 148/92 mm Hg, pO2 98% on room air, Ht 5′4″, Wt 90.7 kg
++
Well-groomed female in moderate distress
++
++
Clear to auscultation, no crackles or wheezing
++
++
Normal BS, abdomen soft and tender
++
A&O ×3, CN II-XII grossly intact
++
Right knee is edematous and erythematous; knee feels stable but warm to the touch
++
+
+
++