Acute Traumatic Knee Pain: A Case Of An Unexpected Incidental Finding - Page #1
 

Author: Dennis Jackson, MD
Senior Editor: Kristine Karlson, MD, FAMSSM
Editor: Kamran Karim, DO

Patient Presentation:
A 22 year old male presented to clinic with acute traumatic knee pain one day after falling from his motorcycle.

History:
The patient rode his motorcycle about 20 miles per hour when the bike fell to the side as he came to a stop, which caused him to fall forward and land directly on the right knee. He experienced significant swelling and pain that worsened with walking, running, and when changing directions. He was able to bear weight with some instability, but denied any associated locking or catching of his knee. He denied any fevers, chills, radiating pain, or paresthesia. At his two week follow up, he continued to have persistent pain and swelling despite improvements in range of motion.

Physical Exam:
Appearance: Significant suprapatellar swelling noted initially, swelling moderately improved but still present at follow-up.
Palpation: Tenderness to palpation over the quadriceps muscles and tendon attachment, tenderness to palpation over the proximal medial collateral ligament on both initial and follow-up exams.
Range of Motion: 0-75 degrees initially, 0-120 degrees at follow-up exam.
Strength: Extension 3+/5 limited by pain, otherwise 5/5 strength bilaterally in lower extremities.
Sensation: Intact to light touch bilaterally on both examinations.
Collateral ligaments: laxity without clear end point with valgus stress at 30 degrees, no pain or laxity with varus stress at 0 and 30 degrees, similar on both initial and follow-up exam.
Negative Lachman, negative posterior drawer.
Equivocal McMurray secondary to pain and limitations with full flexion on initial exam, negative Mcmurray on follow-up exam.

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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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