Author: Ryan Stempniak, MD
Co Author #1: Daniel Smoots, MD
Senior Editor: Natalie Stork, MD
Editor: Elizabeth Portin, DO
A 17-year-old female presented with acute on chronic history of left knee pain. Pain had been present for a few years however acutely worsened over the past few weeks.
She initially presented to her primary care provider however was quickly referred to Sports Medicine for further evaluation. Her acute symptoms began 3-weeks prior to evaluation. The symptoms started after starting a new job at a movie theater. However, she did report a history of intermittent chronic left knee pain over the past few years. Certain movements exacerbated her pain, most notably going up and down stairs. She also noted that cold weather and putting on socks worsened the pain. She described the pain as constant, dull and located in the suprapatellar, lateral, and medial knee with occasionally radiation to her left hip. She noted knee swelling, and the patient's mom felt that the patient's knee seemed unstable. She denied any knee trauma or injury. She was taking Motrin 600 mg twice daily, which provided some relief, and she reported minimal pain relief from wearing a knee brace.
She did have a history of genu varum requiring bracing from age 2 to 4 1/2 years old.
BP - 111/64
HR - 87 BPM
Temp - 97.7 degrees Fahrenheit
Weight - 186 lbs
Height - 5'3"
General: Alert and oriented. No acute distress. Well developed, well appearing teenage female.
Left hip: Limited external rotation, no tenderness over lateral hip.
Right hip: Normal
Right knee: No effusion, no palpable deformity, normal strength, normal range of motion, negative McMurray, negative Lachman, negative anterior drawer, negative posterior drawer, varus and valgus stress negative.
Left knee: No effusion, no palpable deformity, normal strength, normal range of motion, negative McMurray, negative Lachman, negative anterior drawer and posterior drawer, varus and valgus stress negative.
Neurologic: No focal deficits, sensation intact, no lower extremity weakness.
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