Second Shot At Life - Page #1

Author: Marcia Faustin, MD
Co Author #1: Amy Leu, DO

Patient Presentation:
20-year-old male NCAA Division II collegiate basketball player presents to clinic with atraumatic right knee pain for six months.

20 yo M NCAA Division II Collegiate Basketball player presents with chronic right knee pain for six months. Pain described as "deep to the bone." It is located at anterior proximal tibia and radiates down his lateral calf. Occurs at rest and with activity. No swelling or mechanical symptoms. No trauma. No fevers, chills, or weight loss. Four months prior to presentation, he was diagnosed with a right proximal tibial stress fracture by MRI. There was also a lesion noted at medial aspect of proximal tibia, benign in appearance. After three months of rest, pain returned with the initiation of exercise.

Physical Exam:
Vital signs WNL. Well appearing; Right Knee: No effusion; Mild vague tenderness over the lateral proximal tibia, otherwise no other bony tenderness; Full flexion and extension; Normal strength; Neurovascularly intact; All tests negative including: varus/valgus stress, Lachman, anterior/posterior drawer sign, McMurray test, bounce home, patellar grind, Ober's and Noble test.

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