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Uncommon Enlarging Mass Of The Anterior Knee - Page #1
 

Author: Nicolas Gamble, MD
Co Author #1: Elizabeth McBee, DO
Co Author #2: Mark Wisthoff, DO
Co Author #3: Benjamin Fetter, MSc, ATC, OPE-C, CSCS
Senior Editor: Carolyn Landsberg, MD
Editor: Steven Brown, MD

Patient Presentation:
A 77-year-old male presented for evaluation of chronic left anterior knee pain along the patellar tendon with an associated large palpable mass along the anterolateral joint line.

History:
He reported the mass had been present for at least ten years; however, the mass has enlarged over the past year. He stated the mass had never bothered him previously, but as the mass increased in size, he experienced a change in his gait which resulted in left hip and left anterior knee pain. His occupation as a carpenter worsens his symptoms, as it required him to kneel and squat frequently. He denied acute trauma or injury; however, a recent job may have flared up the pain. Aggravating factors included going up and down stairs as well as deep knee flexion. The pain was relieved with rest. No medications were attempted prior to presentation.

Physical Exam:
Left knee exam revealed a large, 5 cm x 5cm, nontender palpable mass overlying the lateral aspect of the patella. The mass medially displaced the patella. The mass is firm and fixed. The patellar tendon was tender to palpation at its proximal and distal bony attachments. The knee exhibited full active and passive range of motion as well as normal strength. Pain was elicited in the patellar tendon with resisted knee extension. Neurovascular examination of the left lower extremity was normal.

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