Knee Swelling In A Swimmer - Page #1

Author: Hunter Buchanan, DO
Co Author #1: Kelly Ryan, DO
Senior Editor: Kevin Gray, MD
Editor: Lacy Knowles, DO

Patient Presentation:
A previously-healthy 12-year-old male swimmer presented with right calf pain and swelling. The week prior, he was jumping off 4-5 foot ledges without injury and had no prior leg injuries. At the time of initial presentation, he was suspected to have a gastrocnemius strain. Two weeks later, he returned to the office with progressive symptoms and was found to have a posterior right knee effusion.

He had no significant past medical history.

Physical Exam:
On exam, he was a well-appearing male, walking on crutches. Right knee had a moderate joint effusion, mild warmth but no erythema. There was no significant calf tenderness. There was no significant tenderness along the patella, patellar tendon or quad tendon. There was normal patellar mobility. Tenderness was noted along the medial joint line. He had full strength with dorsiflexion and plantarflexion. Knee flexion and extension limited from 5 degrees to 90 degrees. There was a negative straight leg raise. No bruising or rashes were noted. Lachman, varus and valgus tests, and Apley's maneuver were negative. No abnormalities with the left knee exam.

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