Author: Jason Epstein, MD
Co Author #1: Steven Frey, MD
Co Author #2: Erik Freeland, DO
Editor: Marc Hilgers, MD, PhD, FAMSSM
Senior Editor: Marc Hilgers, MD, PhD, FAMSSM
17 year old male presented to the office two days following knee to knee collision injury having been non-weight bearing and in a wheelchair since the initial injury.
17 year old male high school football player with a medical history of exercise induced asthma suffered a knee to knee collision with another player during game play. There was no head injury or LOC. He complained of left knee pain and was unable to bear weight or move his knee. He was evaluated by the on-field sports physician and transferred to the hospital for further evaluation.
Gen: Healthy appearing well developed 17 yo male. Vital signs stable.
Neurologic: Sensation of the left leg: L2-L4 normal, decreased sensation of L5 on lateral leg and dorsum of foot. Foot drop noted on left. 0/5 strength in dorsiflexion.
Vascular: 2+ DP/PT L foot.
Musculoskeletal: Inspection of L knee noted swelling but no warmth or erythema with normal axial alignment. Tender to palpation at lateral patellar retinaculum, LCL, IT band, popliteal fossa, biceps femoris tendon and gastrocnemius. Passive ROM L knee 30 degrees flexion and -5 degrees of extension. 3+ gapping and pain present with varus stress test. 3+ Lachman's test without end point. 3+ anterior drawer sign. Left dial test positive at 30 and 90 degrees.
Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.