4.3 of 39 Ratings
A 19-year-old male complains of two week history of knee pain after falling during a college basketball game. Physical exam is unremarkable with no signs of effusion or focal tenderness. In this clinical scenario, which of the following radiographs would warrant continued reassurance and observation?
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A 14-year-old high school running back strikes his left knee on an opposing players helmet during practice. He is able to continue playing for 10 more minutes before seeking medical attention. On examination, he has soft tissue swelling at the anterior knee and early ecchymosis formation. His range of motion was full and no palpable crepitus over the patella was noted. His knee is stable to varus and valgus at 30 degrees. He has a grade one Lachman examination and the medial tibial plateau is anterior to the medial femoral condyle upon a posteriorly directed force on the proximal tibia. There is less than one-quartile of medial and lateral patellar translation with a negative "J" sign. Radiographs are shown in Figures A-C. What is the most appropriate next step in management.
Magnetic resonance imaging (MRI) for ligament reconstruction planning
Immobilize in 120 degrees of knee flexion for 24 hours and return-to-play in 2 weeks
Open reduction and internal fixation with interfragmentary screws with return-to-play in 5 months
Symptomatic treatment with return-to-play as tolerated
Long leg cast for 6 weeks with toe-touch weightbearing precautions with return-to-play in 2 months