Welterweight Wrestler With A Heavyweight Nerve - Page #1

Author: Jeremy Roberts, MD
Co Author #1: Scott Klass, MD
Co Author #2: Christopher Visco, MD
Senior Editor: Carolyn Landsberg, MD
Editor: Andrea Aagesen, DO

Patient Presentation:
17-year-old male high school wrestler with a history of anxiety presenting with one year of chronic knee pain.

He presented with anterior knee pain located at the right patellar tendon. It was described as a jolt that radiated a few centimeters inferiorly. There was no inciting event or injury, but he thought it may have been attributed to repeated wrestling mat contact when taking shots for takedowns. It was associated with numbness and hair loss. It was worse with impact and relieved by rest. He previously completed three months of physical therapy which worsened his pain. Previously, he was treated with three patellar tendon anesthetic and corticosteroid injections which only relieved pain for a few hours each. He had previously sustained a MCL sprain about 1 year ago. He rested for a few months after this injury, but pain return upon resuming wrestling.

Physical Exam:
There was an area of hair loss over the tibial tuberosity (measuring approximately 3 X 5 centimeters). There was diminished sensation and sensitivity along the inferior and lateral aspect of the knee. There was pain to palpation over the mid-patellar tendon. He had full knee range of motion and 5/5 strength with right knee flexion, knee extension, and all hip and ankle motions. Special testing was negative for instability or signs of meniscal tear.

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