Joint pain post op surgery

[ChrisPAinED]

Hi I was greeted by a patient who came in with joint pain. Patient brought her X ray from pre op surg..... 8 years ago! 

The patient came in thinking this new joint pain was caused by her surgery she had. So after re-ensuring her and doing a X ray which was normal, labs (CBC and CRP) and even a ultrasound. Patient was really worried about this and being quite disrespectful to me and the whole team. I got pushed into a few test that I didn't think was necessary like the ultrasound and a lesson that I was reminded and would like to teach to PA students is don't get pushed into unnecessary test because of a patient. Order what you think is necessary and talk with the patient. Explain why that isn't necessary, don't be dismissive and just say no but explain. On this case I should have followed this lesson that I have been taught many times before.

By the way couldn't leave with a cliffhanger.

X ray, labs, and ultrasound were normal

Exam was good

And after a good history that her pain improved with a NSAID

I discharged with a follow up recommendation to her PCP and told her she can take OTC until she see's her doc. 

And I will post the old x ray with consent from the patient and privacy is secured along with a few days to give a non exact time. Also it was so old it wasn't even a digital copy