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Teenage Girl Knee-ding Some Stability - Page #1
 

Author: Anna Bergquist, MD
Co Author #1: Gaurav Singh, BS
Co Author #2: Rebecca Peebles, DO, CAQSM, FAAFP
Co Author #3: Justin Bartley, MD, FAAOS, FAANA
Senior Editor: Christian Fulmer, DO, FAMSSM
Editor: Derrick Miller, MD

Patient Presentation:
15-year-old right-handed female with a medical history of autosomal dominant multiple synostosis, anemia, anxiety, and migraines presented with bilateral knee pain that had recently worsened due to increased physical activity.

History:
The patient reports the pain as 7/10; present for years but worsening recently due to increasing activity while "showing livestock with FFA". Patient describes the pain as aching, dull, continuous, and agonizing; subjective instability present while walking on uneven terrain. Pain is exacerbated by activity, knee flexion and extension, cold temperatures, and prolonged sitting or standing. The patient has restrictions with squatting, kneeling, pivoting, running, jumping, and cutting. The patient denies previous patellar dislocations or patellar instability. She also denies a history of trauma or injuries. Additional positive review of symptoms includes fatigue, back pain, joint swelling, muscle aches and weakness, swollen lymph nodes and anxiety.

Physical Exam:
General appearance: no acute distress HEENT: Oropharynx clear Neck: Supple Cardiovascular/Pulmonary: Regular rate and rhythm. Lungs are clear to auscultation bilaterally with no audible wheezing Musculoskeletal: Bilateral knees: Positive medial and lateral joint line tenderness. Positive Lachman and Posterior drawer. Negative patellofemoral grind and crepitus, patellar apprehension, McMurray's, varus and valgus stress in full extension and 30-degree flexion. Reciprocal heel to toe gait, neutral knee alignment, no effusion. Motor strength: 5/5 Bilat LE. Sensation to light touch intact in all peripheral nerve distributions. No skin lesions or erythema. Vascular: warm, well perfused with good capillary refill.

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NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.
 

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