Spike And Strain A Case Of Knee Pain In A Volleyball Player

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Spike And Strain A Case Of Knee Pain In A Volleyball Player - Page #1

Author: Suleman Janjua, MD Co Author #1: Nicholas Moore, MD Co Author #2: Tariq Awan, DO Co Author #3: Archan Patel, DO Senior Editor: Justin Mark Young, MD, FAMSSM Editor: Robert Oh, MD, MPH Patient Presentation: A 23 year old collegiate volleyball player presented to the clinic with a 5 day history of left knee pain. History: The pain began after she was playing volleyball, dove for the ball, and hyperflexed her knee. She subsequently felt a pop, which led to significant pain. She then collapsed to the floor and had difficulty ambulating. She was unable to finish the game and has since had worsening pain and swelling of her left knee. Since the injury, she has been unable to bear weight and has been using crutches to ambulate. The pain was initially in the posteromedial aspect of the left knee, but has become more lateral. She described the pain as a throbbing, achy, 8/10 level which improved with rest and was exacerbated with walking. She tried a knee brace and ibuprofen without relief. The patient also had a previous left knee anterior cruciate ligament (ACL) reconstruction surgery in 2020. Physical Exam: LEFT KNEE: Inspection - no swelling, no ecchymosis or deformity, neutral alignment Palpation - no crepitus. Nontender quad tendon, patellar retinaculum/tendon, tibial tuberosity, pes anserine bursa, medial and lateral collateral ligaments, and medial joint line; TENDER lateral joint line. Active Range of Motion - 100 flexion and 10 degree extension Strength - 5/5 knee flexion, 5/5 knee extension Stability - no laxity with varus or valgus stress at 30 degrees and 0 degrees, neg anterior/posterior drawer/Lachman, unable to Pivot-shift Special Tests - neg McMurray medially, + McMurray laterally, neg Patellar Apprehension/Laxity/Grind/Impingement Neurovascular - 2+ dorsalis pedis and posterior tibial pulses, intact to light touch and sensation Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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