Bilateral knee pain in a high-level gymnast

Area of Science:

• Sports medicine
• Pediatric orthopedics
• Biomechanics of gymnastics

Background:

• Distal radial physeal injuries are common in gymnasts, leading to chronic pain and growth disturbances.
• Overuse stress injuries in young athletes, particularly gymnasts, are underreported beyond the wrist.
• Understanding the spectrum of overuse injuries in gymnasts is essential for timely diagnosis and management.

Observation:

• A prepubescent female gymnast presented with chronic bilateral knee pain.
• Clinical examination and imaging revealed bilateral distal femoral physeal stress injuries.
• The patient's clinical course mirrored that of gymnasts with distal radial physeal injuries.

Findings:

• Distal femoral physeal stress injuries can occur in gymnasts, presenting as chronic knee pain.
• These injuries share similarities in clinical presentation and course with gymnast's wrist (distal radial physeal injuries).
• Bilateral involvement of the distal femur highlights the systemic impact of repetitive stress in this population.

Implications:

• Broadens the understanding of overuse injuries in gymnasts beyond the wrist.
• Highlights the need for evaluating knee pain in gymnasts for potential physeal stress injuries.
• Emphasizes the importance of early diagnosis and appropriate management to prevent long-term complications in young athletes.