Author: Bernadette Pendergraph, MD
Co Author #1: Marvin Ambriz, MD
Senior Editor: Marc Hilgers, MD, PhD, FAMSSM
Editor: Richard Uribe, MD, MPH
Patient Presentation:
14 year old male soccer player presented with left knee pain for one year.
History:
He complained of left knee pain and swelling for one year. He denied any traumatic injury or new inciting activities at the onset. His pain initially worsened with prolonged sitting, standing, and weight bearing activities, but at examination it was constant and sharp in the anterior and medial aspect of his left knee with radiation to the left hip. He had intermittent swelling but denied any giving way or locking symptoms. He had tried a hinge knee brace, topical sporting creams, acetaminophen, and ibuprofen without any relief. He denied any fevers, weight loss, night sweats, or back pain.
Physical Exam:
His vital signs were normal except for a BMI at the 99%. He appeared comfortable with a moderate effusion of the left knee. His range of motion was 5 to 100 degrees. He had no tenderness of the patellar facets, quadriceps tendon, or joint line. He had tenderness at his inferior pole of the patella and medial femoral condyle. He had no laxity on exam. He was able to do a straight leg raise. His gait was antalgic. He had no erythema or warmth of his knee. His hip range of motion was normal.
Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.