Knee pain and injury workflow

Scope

Use for

Outpatient knee pain assessment for stable patients without immediate limb-threatening findings.

Not for

• Open injury, neurovascular compromise, or septic joint emergency.
• Hospital-level acute orthopedic trauma management.

Immediate actions

• Clarify injury mechanism, instability features, and weight-bearing ability.
• Screen quickly for fracture, septic-joint, and neurovascular red flags.
• Determine initial disposition and imaging necessity using decision rules.

Red flags: escalate now

• Inability to bear weight with high fracture suspicion.
• Hot swollen joint with systemic toxicity concern.
• Progressive neurovascular deficits or severe instability.

First-line plan

• Begin conservative pain/function plan when high-risk features are absent.
• Use imaging only when rule criteria are met.
• Set realistic recovery expectations and escalation boundaries.

Follow-up and monitoring

• Reassess pain, function, and swelling trajectory.
• Escalate for worsening instability, swelling, or infection concern.
• Refer if persistent functional limitation or suspected structural injury remains.

Before the patient leaves

Return precautions you can say as written:

“If symptoms get worse, new warning signs appear, or you cannot follow the plan from this visit, seek urgent care now.”

• Point to the red flags above that apply to this patient.
• Confirm follow-up timing and where to go after hours.
• Attach a relevant handout to reinforce the plan.
• Document disposition, rationale, unresolved uncertainty, and that precautions were understood.

About this workflow

Clinical owner

Family Medicine Editorial Team

Risk tier

Low

Review cadence

Every 12 months

Last reviewed

February 7, 2026

Review status

Current. Next review due February 7, 2027.

References

• Choosing Wisely Canada recommendations (opens in a new tab)
• Toward Optimized Practice clinical practice guidelines (opens in a new tab)