Author: Richard Ross, MD
Editor: Bryant Walrod, MD
Senior Editor: Kristine Karlson MD
The patient is a thirteen year old female with no medical problems. She presented to the sports medicine clinic with a chief complaint of right knee pain while dancing in ballet or jazz, or while running in PE class. She described the pain as a sharp pain that is then followed by a dull ache that would last approximately one hour. There was no radiation of pain. The pain was relieved with ibuprofen and ACE wrapping. The patient denied any numbness, tingling, or weakness. Review of systems was otherwise negative.
On exam, there was an obvious asymmetry of the right distal anteromedial thigh, relative to the left, with two large prominences, approximately 3-4 centimeters apart, that were very firm, immobile and non-tender. There was no effusion and the overlying skin appeared normal. Range of motion testing showed no deficits, however knee flexion caused a mild pain in the area of firmness. Ligamentous testing was normal. Strength was 5/5 throughout, distal sensation was intact. PT and DP pulses were +2 and symmetric.
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