Author: Brandon Eck, BS
Co Author #1: Brian Solkalsky, DO
Co Author #2: Fotios Tjoumakaris, MD
Editor: Thomas Pommering, DO
A 16 year old, white male fell on his right knee while playing basketball 3 weeks prior to presentation.
At the time of injury he had minimal pain or swelling; however, a few days later the patient noticed the accumulation of fluid over the anterior aspect of the knee. Despite the appearance of his knee, he felt his knee to have full range of motion without significant pain. He reported a couple of episodes (2-3) of the knee giving way on him. Upon further questioning, the patient reported 3 to 5 similar swelling episodes over the past couple of years. Ibuprofen alleviates his symptoms as does resting the joint. The patient denies constitutional symptoms. Past medical history is significant for ADHD controlled with medication. Social history reveals that he is adopted and currently living with his father.
He is 5 ft 3 inch, 140 pound well-appearing male in no acute distress. He is awake, alert and oriented x3. He has a pulse of 60 beats per minute. Inspection of the knee demonstrates diffuse anterior swelling of the knee in a horseshoe configuration surrounding the patella. There is normal quadriceps tone, no effusion, and near full range of motion. The medial and lateral joint lines are non-tender and the ligamentous examination is stable (negative Lachman, pivot shift, and no varus or valgus laxity). There is tenderness to palpation over the prepatellar fluid. There is no erythema, or drainage.
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