Author: Chris Hong, DO
Co Author #1: Ralph R Franks, DO FAOASM
Senior Editor: Kristine Karlson, MD, FAMSSM
Editor: Rahul Kapur, MD
Patient Presentation:
Acute left knee pain
History:
A 47-year-old female, an avid runner and former collegiate soccer and lacrosse player with a history of arthroscopic meniscus repair on her left knee in 1998, presented to a sports medicine practice complaining of acute left knee pain for one week. She had been experiencing persistent left knee pain with associated mechanical symptoms, including locking and knee instability during activities. The pain was rated at 4 out of 10 and was located in the left popliteal fossa. She described the pain as a 'fullness' with associated tenderness upon palpation and paresthesias on the plantar aspect of her left foot. The radiculopathy was exacerbated by extending her knee. The patient had been running 6 miles per day.
Physical Exam:
Patient appeared to be alert, well-appearing, and not in acute distress. She exhibited a mildly antalgic gait, favoring the left side. There were well-healed prior arthroscopy portal sites on her left patella. A palpable, soft, and compressible mass was found in her popliteal fossa, which was tender to palpation. Mild patellofemoral crepitus was present. Significant tenderness was noted upon palpation over the medial joint line. She displayed full active and passive range of motion, with 5/5 motor strength, and a neurovascular intact examination of the left lower extremity. The knee was stable during Lachman testing, and both Steinman's and McMurray's tests yielded negative results.
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