Knee and shoulder pain are common complaints for patients in the primary care office.
But identifying the source of the pain can be complicated, and an accurate diagnosis of the underlying cause of discomfort is key to appropriate management — whether that involves simple home care options of ice and rest or a recommendation for a follow-up with a specialist.
Speaking at the 2022 American College of Physicians Internal Medicine Meeting, Greg Nakamoto, MD, Department of Orthopedics, Virginia Mason Medical Center, Seattle, Washington, discussed common knee and shoulder problems that patients often present with in the primary care setting, and offered tips on diagnosis and appropriate management.
The most common conditions causing knee pain are osteoarthritis and meniscal tears. "The differential for knee pain is broad," Nakamoto said. "You have to have a way to divide it down, such as if it's acute or chronic."
The initial workup has several key components. The first steps: Determine the location of the pain — anterior, medial, lateral, posterior — and then whether it stems from an injury or is atraumatic.
"If you have to ask one question — ask where it hurts," he said. "And is it from an injury or just wear and tear.
