Module 51, General Medical Level

This patient is a 12 year old male who initially presented with a history of left knee pain for 4 months. He denied any obvious history of trauma, but he claimed to play a lot of basketball and felt that the pain was worse after playing. Patient also claimed to have a "knot" over the anterior aspect of his proximal tibia. On physical examination the patient had a prominent tibial tubercle which was warm, swollen, and tender. The knee did not have an effusion, and there was no joint line tenderness. There was also no tenderness over the patellar tendon.

Question 51A

The work up should focus on obtaining a CBC, SER, Rheumatoid factor levels.

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Question 51B

Playing basketball is the direct cause of this condition and the boy should be encourage to decrease his basketball playing time.

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Question 51C

This boy is probably in rapid phase of growth which is partly the cause of his symptoms.

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Question 51D

As part of the treatment this boy should be encouraged to take non-steroidal anti-inflammatory medication.

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Question 51E

You tell the boy that if he does not limit his basketball playing he will permanantly damage his knee.

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