Author: Samuel Galloway, BA
Co Author #1: Aaron Gray, MD
Co Author #2: Andrea Evenski, MD
Editor: Jennifer Daily, MD
A 15-year-old previously healthy football player was referred to sports medicine clinic by his primary physician and athletic trainer for 2-3 years of left knee pain and measured muscle atrophy in his left leg.
The patient's pain was located along the anterior and lateral aspects of his left knee with occasional pain radiating up to his hip and down to his foot. It was 6/10 in severity, made worse with running or weight bearing activity, and improved with rest. It was associated with occasional swelling. He also had some pain at night. Denied any history of trauma or injury, denied popping, catching, locking, or giving way. No warmth, redness, or bruising. No fevers, chills, weight loss, or night sweats.
Well appearing teenage boy in no acute distress.
Vital signs within normal limits.
Right knee exam normal.
Left knee: No erythema, warmth, effusion, or visible mass. Strength 5/5, reflexes normal, sensation intact. Normal stability, normal meniscus and ligamentous exams. Tenderness to palpation over lateral femoral condyle. He lacked approximately 5 degrees of full extension, and had flexion to 110 degrees with pain on both extremes of flexion and extension.
Left leg: visible atrophy of the left quad and calf muscles.
Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.