Lucas G. Teske, MD

A 15-year-old boy with no significant past medical history arrives to clinic for evaluation of left knee pain and swelling after sustaining a non-contact injury 2 days earlier while playing baseball. The patient states he was running from third base to home and felt a sudden sharp pain and a pop in his left knee when his foot struck the plate. He reports that his knee became significantly swollen the night of the injury. He has been able to bear weight for the last 2 days. When asked to localize his pain, he points to the anteromedial and anterolateral aspects of the left knee. The pain has subsided in the last day; however, he still has some discomfort and rates his pain as a two out of 10. The patient describes having a subjective feeling of instability. He denies a history of other injuries or surgeries to the left knee. Review of systems was negative aside from that stated above.

A 12-year-old boy with a past medical history of left iliac crest bone graft for pharyngoplasty/cleft palate repair performed 5 years prior to presentation arrived at our clinic with anterior left hip pain, which has been waxing and waning since the bone graft procedure. He denies any new or recent trauma. During the past month, he noted significant worsening of his pain. The pain was severe enough to keep him out of school for the past 2 weeks. When asked to localize the pain, he demonstrated the ‘C’ sign, cupping his lateral hip with his hand in a ‘C’ shape. He stated the pain does not radiate nor does he endorse mechanical symptoms. The pain is worse at night and it has now limited his weight-bearing to the point of needing crutches to ambulate. He has tried physical therapy (PT), NSAIDs and narcotics without relief of his symptoms. He denied any constitutional symptoms.