Unusual Cause Of Knee Pain In A 16 Year Old Soccer Player - Page #1

Author: Ronald Tsao, MD
Co Author #1: Jeffrey M. Mjaanes, MD
Editor: Peter Seidenberg, MD

Patient Presentation:
A 16 year old male high school soccer player presents two days after an injury to his right knee.

During a game, he attempted to kick a ball and got his leg caught in between two defenders and thought he may have twisted his knee. He was evaluated by an athletic trainer on the field who thought he may have sustained an ACL/LCL injury. He was unable to bear weight immediately after the injury. He was made non-weight bearing on crutches, iced, and elevated the leg over the next 36 hours.

Physical Exam:
No ecchymosis. There is a trace knee effusion. Distal thigh circumference on the right is 3 cm greater than the left. He is diffusely tender to palpation over the right distal thigh. No tenderness over proximal fibula or tibia. He lacks 15 degrees of full extension and can flex to 80 degrees. He is tender over the LCL, medial joint line, and medial femoral condyle. He has a 1A Lachmanís and negative pivot shift. He has pain with varus and valgus stressing but has firm endpoints. Posterior drawer and McMurray's tests were limited due to pain and lack of motion. Distal pulses were intact.

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