John Smith, M.D.
PO Box 594
Waverly, OH 45690
888-448-1011

May 12, 2015

Re: GI Joe II and his bilateral knee conditions.

To whom it may concern,

My name is Dr. John Smith and I am reaching out in regards to GI Joe II and his bilateral knee conditions. I am familiar with this veteran’s knee conditions and have reviewed his service treatment records and private medical records.

While the veteran was on active duty he was seen on multiple occasions by medical providers and diagnosed with patellofemoral pain syndrome of both knees.

Following military service the veteran’s statement reports that he continued to have pain in both knees.

In 2013 MRIs of the knees showed wear and tear of the cartilage behind the knee cap and was diagnosed with Grade III chondromalacia patella.

It is my expert medical opinion that the veteran’s patellofemoral pain syndrome and chondromalacia patella of both knees is more likely than not directly related to military service.

The rationale:
The veteran was diagnosed with patellofemoral pain syndrome of both knees in service. The MRI from 2013 demonstrates a progression of the diagnosed knee conditions in service. The progression supports a chronic ongoing condition of the patellofemoral pain syndrome from service.

To further support the rationale, medical literature reports that development of chondromalacia patella is the result of chronic patellofemoral pain syndrome due to anatomical stressors upon the knee.1

The veteran demonstrated an injury in service.

The veteran has a current diagnosed disability.

A medical nexus has been established.

Please reach out if you have any questions regarding this case.

Sincerely,

Dr. John Smith, M.D. /es/