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Published on: February 22, 2019
Adolescent knee pain: fracture or normal? A case report
1Division of Graduate Studies, Canadian Memorial Chiropractic College.
Background:
Knee injuries are the second to fourth most common injuries in youth soccer. In this population, sprains/strains, fractures and contusions are most common. Due to variations in the developing skeleton, it can be difficult to rule out fractures.
Case Summary:
We present a case of a 13-year-old presenting to the emergency department (ED) with patellar pain after pivoting during a soccer game. After radiographic clearance, he was allowed to return to sport. Following another fall and ED visit, his full leg was casted. He presented to a chiropractor after cast removal, who made recommendations for progressive rehabilitation owing to the lack of evidence for fracture on radiographs.
Summary:
We suggest a thorough history, physical and Ottawa knee rules to determine whether radiographs are indicated in the management of a pediatric knee injury. Due to normal skeletal variance, we recommend bilateral radiographs and if findings are ambiguous, consultation with a radiologist to confirm clinical suspicions.
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