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Suspicious Swelling: An Atraumatic Knee Effusion In A High School Basketball Player - Page #1
 

Author: Daniel Kelley, MD
Co Author #1: Dr. Brendon Ross
Senior Editor: Kristine Karlson, MD, FAMSSM
Editor: Tony Reed, MD, FAMSSM

Patient Presentation:
16-year-old male with deep left knee pain for 4 days.

History:
A 16-year-old male with a past medical history for a healed left distal femur Salter-Harris Type 2 fracture presented with deep left knee pain and swelling for 4 days following a basketball game. He could not recall a specific injury and was not having a sense of instability in his knee. He thought it may be catching and locking, but could not be more descriptive. It worsened with weightbearing and had not improved despite a compressive wrap since the onset of the swelling. He had no numbness, tingling, or radiating pain in his left leg. He had no prior surgeries, took no medications, had no documented allergies, was a high school student living with his parents, and had no significant family history.

Physical Exam:
On physical examination, he appeared overweight with an antalgic gait but was in no acute distress. The left knee exam revealed moderate effusion without erythema. He had an active range of motion from 0 to 110 degrees with posterolateral pain at terminal flexion. He had tenderness in the superior patella pole and along the lateral joint line. His strength and neurovascular status were intact. Special testing demonstrated a negative Lachman's posterior drawer, varus and valgus stress pain or laxity, McMurray's, and Dial test.

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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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