Module 63, General Medical Level

This 16 year old, 220 pound male presented to the emergency room after sustaining an acute injury to his right knee while playing baseball. The patient related that he noticed acute onset of pain in the Right knee after striking out at bat. He heard a single clunk in his knee and noticed immediate pain and swelling. On examination he was noted to have medial knee tenderness with a mildly positive apprehension test. His ACL, PCL, MCL and LCL ligaments were intact.

Question 63A

This is consistent with a mild knee sprain and he should be placed in a splint and encouraged to return to sporting baseball in several days when all his tenderness has resolved.

Question 63B

This type of injury can cause a patellar dislocation so a careful examination of the patella is indicated.

Question 63C

The first test to obtain in the further work up of this injury would be an xray of the hip.

Question 63D

This type of history with a patient being able to walk into the emergency room means that he is very unlikely to have a fracture in the knee.

Question 63E

The a boy of this size and with this injury history he most likely has a Salter 1 fracture of the distal femoral epiphysis.

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