Module 49, General Medical Level

A 13 year old boy presented with left knee pain after sustaining an injury while wrestling three months prior to this visit. The patient stated that his left knee was in a hyperflexed position when it was twisted. He felt a "pop" associated with pain on the lateral aspect of his knee. He stated that he had minimal knee swelling which had resolved, but his pain persisted.

Question 49A

The complaint in the knee currently is likely related to the trauma from wrestling.

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Question 49B

The most important next step after the above information is to obtain a CBC, ESR, and Rheumoid factor level.

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Question 49C

The first imaging study to obtain is an x-ray of the knee.

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Question 49D

The boy weighs 93 KG and lies on the bed with his legs externally rotated. AP and lateral x-rays must also be obtained.

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Question 49E

Because of his young age and usual ligamentous laxity significant ligament injury is a very unlikely cause of his symptoms.

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