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Article Title

Knee Pain – High School Wrestler

Abstract

N. Ferrarini, G. Rozea, K. Vanic, J. Hauth, East Stroudsburg University, PA. email: grozea@esu.edu (Sponsor: K. N. Waninger, FACSM)

HISTORY: A 14-year-old male wrestler presented with left posterior knee pain. The athlete could not describe a specific mechanism for the injury/condition. Pain has developed progressively/insidiously and shifted to the medial side of the knee with further joint line pain complaints. Past medical history unremarkable for any previous knee injury.

PHYSICAL EXAMINATION: No swelling or ecchymosis was noted in knee region. Slight pain described with palpation in the posterior left knee. Ligamentous stress tests were negative for pain or joint laxity (anterior drawer, posterior drawer, valgus and varus tests at 0° and 30°). No neurological or vascular changes noted. No range of motion or strengths deficits.

DIFFERENTIAL DIAGNOSIS: Posterior cruciate ligament pathology, medial meniscus tear, medial cruciate ligament pathology

TEST AND RESULTS: AP and lateral x-rays were negative for any fracture. Activity was restricted until orthopedic clearance. MRI revealed apparent bony exostosis near proximal growth plate along with pes anserine bursitis.

FINAL/WORKING DIAGNOSIS: Solitary tibial osteochondroma in the left knee.

TREATMENT AND OUTCOMES: The patient was referred to physical therapy three times a week for 4-6 weeks consisting of quad sets, towel crushes, short arc quads, straight leg raise, hip abduction, prone hip extension, quarter squats, theraband press backs, hamstring and gastroc/soleus stretching. Rehabilitation caused continued pain in the left knee. Cortisone injection was administered in the left medial knee joint. Athlete undergoes periodic routine evaluation and diagnostic examination to identify any changes or complications.

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