Module 55, General Medical Level
This patient is a 14 year and 6 month old black male with a one year
history of progressively worsening left knee pain. He states that the pain
began in both knees and was intermittent, Tylenol helped to alleviate the
pain. Over the past 6 months the pain is more isolated to the left knee
and has become constant in nature. Within the last 2 weeks the constant
pain has become bad enough to limit his activities. He is unable to attend
school or walk more than several hundred feet because of the pain. The
pain is now affecting his sleep. The adolescent is a morbidly obese black
male. His extremity exam reveals an asymmetric pelvis with the right being
elevated. There is a leg length inequality with the left leg being about
3.5 cm shorter than the right.
Question 55A
This
boy has had this same problem since early childhood.
Question 55B
The correct treatment requires the application of double upright Knee Ankle
Foot Oorthosis for protection of the knee joints during ambulation.
Question 55C
The cause of this boy's pain is probably due to an inflammatory process
and he should have a full arthritis work up.
Question 55D
This
boy has four other brothers and it is not likely that one of them also
has this condition.
Question 55E
The best treatment of this condition is surgical.
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