Pigeon Toed Quarterback

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Pigeon Toed Quarterback - Page #1

Author: Dan Stover, MD Co Author #1: Sigrid Wolf, MD Senior Editor: Justin Mark Young, MD Editor: Christopher Carbullido, DO, MPH Patient Presentation: Bilateral knee pain History: A 15 year old male presented with 1 month of intermittent bilateral knee pain. His pain was located over the anterior distal knee, bilaterally. His pain started gradually while playing basketball and football during the same season. It was worse after sports, running, and jumping. He reported knee instability during his painful episodes. The pt denied any inciting event or trauma. He tried icing, stretching, and ibuprofen with limited improvement. He was still participating in football, but felt that he couldn't perform at his full strength due to his discomfort. The pt denied any swelling, numbness, or pain in other joints. HIs family had noticed painless intoeing on his left side for some time but were unsure of its chronicity. The pt's past medical history was significant for prior rotator cuff strain, trapezius strain, and Sever's apophysitis. Physical Exam: Knee Inspection: no swelling or bruising Palpation: TTP over tibial tubercle bilaterally ROM: Full and symmetric Strength: Normal Special tests: Positive Ober's test and Ely's test bilaterally Negative Lachman, Posterior drawer, McMurray, Valgus stress, Varus stress, patella compression/apprehension/patellar mobility testing Hip ROM: Painless with limited internal rotation on the left Gait: Left intoeing, non antalgic Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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