Analyze the possible conditions from your colleagues’ differential diagnoses: Osgood Schlatter Disease
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Analyze the possible conditions from your colleagues’ differential diagnoses. Determine which of the conditions you would reject and why. Identify the most likely condition, and justify your reasoning.
Case: A 15-year-old male reports dull pain in both knees. Sometimes one or both knees click, and the patient describes a catching sensation under the patella.
Osgood Schlatter Disease- This is the primary diagnosis and it is most common in active boys who are in the fast growth stage. It presents with pain below the kneecaps and the pain can become intense especially after high-impact sporting activities that put a strain on the quadriceps muscles (Ryan, Maryam, & Hue, 2016).
Patellar dislocation- This is a probable differential diagnosis based on the patient’s chief complaint of dull pain in the bilateral knees followed by occasional clicking. The strain on both knees could be a result of his athletic activities and engagement in sports which included a lot of jumping and running thus straining both knee joints (Rudavsky & Cook, 2014).
Patellar chondromalacia- This is also a likely differential diagnosis because of the presence of pain in the bilateral knees which increases with activity (Pak, Lee, & Lee, 2013). Although this condition affects females and people with a history of trauma, the patient indicated no history of knee trauma. They also cited the absence of any misalignment which is a major cause of the condition. In this case, an x-ray of the knee is important to show irregularities in the patellofemoral joint Ridley, U., & Ridley, L. (2020).
Patella fracture- This differential diagnosis occurs when there is breakage of the kneecap and when there is cracking (Reinking, 2016). These two conditions result in pain of the knee and may be accompanied by bruising and swelling around the injured knee. Although the patient has not presented with these symptoms, there is still a likelihood of the fracture which can be verified through a radiology test.
Medical Meniscus-There is a possibility of this diagnosis because it occurs when there is a twisting of the knee hence causing injury. For this patient, twisting might have occurred due to sporting activities such as basketball and soccer that entail twisting movements. The presence of clicking of the knees may be an indication of a meniscus tear (Wu et al. 2018).
Pak, J., Lee, J. H., & Lee, S. H. (2013). A novel biological approach to treat chondromalacia patellae. Plos One, 8, 5.
Reinking, M. F. (2016). Current concepts in the treatment of patellar tendinopathy. International Journal of Sports Physical Therapy, 11, 6, 854-866.
Ridley, U., & Ridley, L. (2020). Imaging of the knee:’Common acute presentations to general practice’. Australian Journal of General Practice, 49(6), 344-349.
Rudavsky, A., & Cook, J. (2014). Physiotherapy management of patellar tendinopathy (jumper’s knee). Journal of Physiotherapy, 60, 3, 122-129.
Ryan, A. D., Maryam, M., & Hue, H. L. (2016). Review of Osteosarcoma and Current Management. Rheumatology and Therapy, 3, 2, 221-243.
Wu, J. L., Lee, C. H., Yang, C. T., Chang, C. M., Li, G., Cheng, C. K., Chen, C. H., Lai, Y. S. (2018). Novel technique for repairing posterior medial meniscus root tears using porcine knees and biomechanical study. Plos One, 13, 2.