Lateral Knee Pain in 16M Competitive Tennis Player

HPI

The patient is a 16-year-old male competitive tennis player who presents with lateral knee pain that has been ongoing for several months. He denies any specific inciting injury. The pain is exacerbated by strenuous activity and has become significant enough to interfere with his ability to continue playing tennis at a competitive level. He has previously attempted taking several months off of tennis without improvement. He has attempted treatment with NSAIDs, ice, and activity modification, but reports limited relief. He has no history of prior knee surgeries.

PMH

Past medical history is noncontributory.

PE

On physical examination, the patient demonstrates full knee range of motion from 0 to 140 degrees. Ligamentous testing reveals a negative Lachman, posterior drawer, and dial test. The knee is stable to varus and valgus stress. McMurray's test is negative. There is tenderness to palpation along the lateral joint line. He has pain with hyperflexion.