A Slide Of Relief

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A Slide Of Relief - Page #1

Author: Ron Rosenberg, MD Co Author #1: Jesse J. Miller, MD Senior Editor: Jessalynn Adam, MD Editor: Daniela Mehech, MD Patient Presentation: A 20 year-old Division I Men's Soccer player suffered a left knee injury during a regular season soccer game after he attempted a slide tackle. History: A 20 year-old Division I Men's Soccer player suffered an injury during the second half of a regular season game. While attempting to slide tackle, his non-dominant left foot was caught beneath his right thigh and the ground while an opposing player simultaneously fell on him. He felt an immediate pop and pain in his left knee. Initial on-field assessment demonstrated neurovascular stability, intact ligaments, and pain over the fibular head. No step off deformity was appreciated. There was also significant left ankle pain with tenderness over the deltoid ligaments and pain with dorsiflexion. He was brought to a standing position, though unable to bear weight on the extremity, and limped off the field with the support of the medical staff. He was then placed in a knee immobilizer and given crutches. Physical Exam: Exam of the left knee showed no effusion. Lachman and posterior drawer tests were negative, there was no valgus laxity. With varus stress testing there was discomfort, but no laxity. There was tenderness to palpation on the medial joint line, over the lateral collateral ligament at its distal insertion on the fibular head, and over the tibiofibular joint. Exam of the left ankle elicited pain over the deltoid ligaments and posterior tibialis tendon. There was no tenderness along the lateral malleolus, nor was there pain over the lateral ankle ligaments, anterior inferior tibiofibular ligament and syndesmosis. Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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