Traumatic knee pain in a child
Autor: | Oliver Beaumont, Robert F. Miller, Henry Claireaux, Jakob van Oldenrijk |
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Přispěvatelé: | Orthopedics and Sports Medicine |
Rok vydání: | 2018 |
Předmět: |
musculoskeletal diseases
Male Knee Joint Radiography Anterior cruciate ligament Knee Injuries Lachman test Avulsion Diagnosis Differential 03 medical and health sciences 0302 clinical medicine medicine Humans Tibia Child Orthodontics 030222 orthopedics business.industry Disease Management 030229 sport sciences General Medicine Emergency department Pivot-shift test musculoskeletal system Arthralgia Tibial Fractures Knee pain medicine.anatomical_structure medicine.symptom business human activities |
Zdroj: | BMJ-British medical journal, 362:k2497. BMJ Publishing Group |
ISSN: | 1756-1833 |
Popis: | A 12 year old boy presented to the emergency department with his parents after falling from a motocross bike. The child was unable to describe the precise history of the event or injury mechanism, but he described experiencing immediate and progressive pain in the left knee and was unable to fully extend the knee or bear weight on that side after the injury. He sustained no other injuries and was haemodynamically stable. On examination, a large effusion in the joint was noticed. Flexion was limited to between 20° and 90°, but the collateral knee ligaments were stable in extension and in 30° of flexion. Anterior drawer and Lachman test suggested grade 1 instability. The pivot shift test was not possible because of patient apprehension. The limb was neurovascularly intact and the boy’s calves were soft and non-tender. Radiographs of the knee were taken (figs 1, 2). Fig 1 Anteroposterior plain radiograph of the child’s knee taken shortly after arrival in the emergency department Fig 2 Lateral plain radiograph of the left knee ### What is the diagnosis? The plain radiographs show a fracture of the tibial spine (aka intercondylar eminence) (figs 3, 4). These are bony avulsion fractures of the anterior cruciate ligament (ACL) along with part of its attachment to the intercondylar eminence of the tibia. Fig 3 Anteroposterior radiographs of the child’s knee, with arrow pointing … |
Databáze: | OpenAIRE |
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