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- W4294796071 abstract "HISTORY: 19 y.o. healthy male rugby player presented for right knee pain. Onset was gradual starting 18 months prior, rated 2-10/10, described as feeling mildly unstable without locking or give-way. Previous evaluation 12 months prior was notable for anterior knee pain on physical exam and unremarkable plain films. Pain was attributed to patellofemoral pain syndrome at that time. He trialed a knee sleeve and physical therapy without significant benefit, prompting follow-up. Since then, he noted progressive, intermittent swelling. Pain was improved with NSAIDs. No increased night pain reported. PHYSICAL EXAMINATION: Inspection/palpation: Mild tenderness to palpation of the medial/lateral patellar facets and femoral condyles. Gait, strength, range of motion, neurovascular exam, and provocative maneuvers were all normal. DIFFERENTIAL DIAGNOSIS: Patellofemoral pain syndrome, Stress fracture, Meniscal injury, Osteosarcoma, Osteomyelitis (Brodie abscess), Osteoid osteoma, Osteochondroma. TESTS AND RESULTS: Right knee plain films: Mild cortical thickening and sclerosis at the lateral aspect of the right proximal tibial metaphysis. Chronic periosteal reaction or adjacent heterotopic ossification. Small amount of rounded lucency in the cortex of the lateral right tibial metaphysis. Due to these findings, MRI of the right knee was obtained, demonstrating: 1.4 cm lesion within the medial cortex of the proximal tibial metaphysis with associated cortical thickening, periosteal new bone formation, and reactive bone and soft tissue edema, most consistent with an intracortical osteoid osteoma. FINAL WORKING DIAGNOSIS: Osteoid osteoma of the right proximal tibial metaphysis. TREATMENT AND OUTCOMES: He was referred to orthopedics for surgical consideration. CT demonstrated a lucent nidus in the cortex of the proximal right tibial metaphysis with surrounding reactive sclerosis, cortical thickening, periosteal new bone formation, soft tissue edema. Case was discussed with radiology, and a pre-procedural biopsy pursued for confirmation of pathology. This confirmed the diagnosis of osteoid osteoma. Patient underwent percutaneous radiofrequency ablation under CT guidance. There were no post-procedural complications and he experienced complete resolution of pain and was able to walk the next day." @default.
- W4294796071 created "2022-09-06" @default.
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- W4294796071 date "2022-09-01" @default.
- W4294796071 modified "2023-09-27" @default.
- W4294796071 title "Right Knee Pain In A Male Rugby Player" @default.
- W4294796071 doi "https://doi.org/10.1249/01.mss.0000875208.69783.69" @default.
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