Orthopaedic and GP Referral Letter

Dear Dr Wiremu,

I am contacting you about my patient, Aroha Taylor (NHI: KLM4829), who attended with persistent anterolateral pain and mechanical catching affecting her right knee. The problem began after a non-contact pivoting injury during netball on 12/08/2023. Aroha Taylor initially saw me on 18/08/2023.

My latest assessment of Aroha Taylor, completed on 06/10/2023, showed the following:

Diagnosis

Suspected right lateral meniscal tear (ACC45: GP884920)

• Imaging or investigations: Plain XR right knee (15/08/2023) NAD; no fracture or joint space narrowing.

Presenting Symptoms

• Sharp lateral joint line pain (VAS 6/10) with intermittent locking and mild joint effusion.
• R knee AROM flexion limited to 110 degrees, extension lag 5 degrees; positive McMurray's and Thessaly's tests laterally.
• Unable to play netball or run; difficulty squatting and descending stairs at work (retail).

Relevant History

• Past medical history: Nil significant; regular ibuprofen (Nurofen®) 400 mg PO TID PRN for pain.
• Previous injuries or conditions: R ankle grade 1 ATFL sprain (2021), fully resolved.

Treatment To Date

Aroha Taylor has received physiotherapy rehabilitation for 7 weeks. This has involved joint mobilisation, VMO/quadriceps strengthening, proprioceptive retraining, and load management. Over the past 3 weeks, their response has been plateaued due to persistent mechanical block and recurrent effusion upon increasing load.

In view of Aroha Taylor’s presentation and response to the current approach, I think an orthopaedic review and MRI of the right knee may help achieve definitive diagnosis and guide potential arthroscopic management.

Please contact me if further information about Aroha Taylor’s case would be helpful. Thank you for reviewing this referral; I look forward to working together to support the patient’s care.