Thrown For A Curveball; A Baseball Pitcher's Unique Injury - Page #1

Author: Peter Mitchell Martin, DO
Co Author #1: Chad Hulsopple, DO, CAQSM
Senior Editor: Rachel Coel, MD, PhD
Editor: Alec Wilhelmi, MD
Editor: Alec Wilhelmi, MD

Patient Presentation:
A 15 year-old male baseball pitcher presented for worsening bilateral anterior knee pain.

A 15-year-old male baseball pitcher followed up after initially being diagnosed with Osgood-Schlatter disease. He received this diagnosis based on worsening anterior proximal tibial pain. His symptoms increased with impact activity and improved with rest. Initial radiograph findings demonstrated mild bilateral fragmented apophyses at the tibial tuberosity. His treatment plan included rest, physical therapy, and non-steroidal anti-inflammatory medication. Despite treatment, his pain persisted and progressed distally to bilateral tibial diaphyses. He denied new or prolonged impact activities or workouts. His pain was most intense at the end of the day and he reported intermittent nighttime pain. He denied any restrictive diets, fatigue, or any gastrointestinal issues such as loose stools or blood in his stool.

Physical Exam:
Bilateral lower extremity examination revealed no gross bony deformity, erythema, ecchymoses, or edema on inspection. On palpation, he exhibited mild to moderate tenderness to palpation near bilateral tibial tubercles and proximal tibial diaphyses. His range of motion with knee flexion and extension was normal and unrestricted. Special examination testing revealed a positive hop test and fulcrum test bilaterally.

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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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