The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to recognize accurately. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case that you would like to suggest for a future Case Challenge, please contact us.
A 16-year-old boy is examined in the emergency department (ED) for acute-onset left knee pain and swelling. Two months ago, he suffered a patellar dislocation that was treated with rest, cryotherapy (ice), elevation, and immobilization. He recovered completely from this episode.
The rest of his medical and surgical history is unremarkable. The family history is negative for knee problems or dislocations. He takes no regular medications and has no allergies. He is a high school student and a semiprofessional soccer player.
This episode of knee pain started a week ago following a soccer match. The knee is moderately swollen and painful. At the onset of symptoms, the patient treated himself with cryotherapy, rest, and an elastic bandage, with mild improvement; however, the symptoms reappeared 3 days ago and have progressively worsened, prompting this visit to the ED.
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Cite this: A 16-Year-Old Boy With Concerning, Recurrent Knee Problems - Medscape - Sep 29, 2011.