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Adolescent knee pain: fracture or normal? A case report
1Division of Graduate Studies, Canadian Memorial Chiropractic College.
The Journal of the Canadian Chiropractic Association
|October 12, 2018
Summary
Pediatric knee injuries in soccer players require careful evaluation. Utilizing thorough history, physical exams, and the Ottawa Knee Rules can help determine the need for radiographs to rule out fractures in young athletes.
Area of Science:
- Orthopedics
- Pediatric Sports Medicine
- Radiology
Background:
- Knee injuries are prevalent in youth soccer, ranking as the second to fourth most common injuries.
- Sprains, strains, fractures, and contusions are the most frequent diagnoses in this demographic.
- Assessing fractures in pediatric patients is challenging due to normal variations in skeletal development.
Purpose of the Study:
- To present a case study of a pediatric patient with patellar pain after a soccer injury.
- To highlight diagnostic challenges and management strategies for pediatric knee injuries.
- To emphasize the importance of appropriate radiographic assessment in pediatric knee trauma.
Main Methods:
- A case report of a 13-year-old male experiencing patellar pain after a soccer event.
- Initial emergency department visit with radiographic clearance, followed by a subsequent injury and casting.
- Chiropractic consultation post-cast removal for rehabilitation recommendations.
Main Results:
- The initial radiographs did not reveal evidence of fracture, allowing the patient to return to sport.
- Despite initial clearance, the patient experienced a subsequent fall and required casting.
- Radiographs lacked definitive fracture evidence, necessitating further clinical suspicion and management.
Conclusions:
- A comprehensive approach including detailed history, physical examination, and application of the Ottawa Knee Rules is recommended for pediatric knee injuries.
- Bilateral radiographs are advised due to normal skeletal variations in children.
- Consultation with a radiologist is recommended for ambiguous radiographic findings to confirm clinical suspicions.
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