Author: Landon Morikawa, MA
Co Author #1: Justin Mark Young, MD
Senior Editor: Kristine Karlson, MD, FAMSSM
Editor: Drew Duerson, MD
Patient Presentation:
An 18-year-old freshman linebacker on a Division I football team presented with left knee pain and mild swelling. A day earlier, he awkwardly twisted his left leg attempting a tackle during a game and felt a twinge in his left knee. He immediately noticed increased knee laxity and was removed from the rest of the game. He took ibuprofen to reduce his pain.
History:
Two years prior, he had a similar injury but with substantially more swelling. At that time, he did not pursue thorough medical evaluation and treatment due to poor access to resources in his home country. Instead, he rested for 2 months after that injury and returned to play when his knee symptoms improved. Otherwise, his medical history was only significant for rheumatic fever at the age of 10, for which he continues to receive monthly Bicillin injections.
Physical Exam:
General: Height 6ft 3in; Weight 245 lbs; Normal temperature.
Cardiac exam: Regular rate and rhythm with no murmurs.
Left knee exam: Lachman test positive with endpoint but 1+ laxity; grade 2. Anterior drawer test positive; grade 2+. Posterior drawer test negative. Range of motion was 100/5 degrees with pain at maximal flexion. Effusion was 1+. Tenderness to palpation over the medial joint line and anterior knee. Varus/valgus stress testing normal.
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