i have just recently seen a 12yr old boy with knee pain. i have sent him for anscan did i do the right thing?
he has been suffering from knee pain in the inferior poles in both legs for 1 year but he recently had a fall on his right knee 1 month ago and is in alot of pain. he has had an x-ray done and was clear. observation showed puffiness of the knee around the patella, and swelling was present girth was 1.5 cm more on his right. on movements ext is painful end range, his flex is limited to 70 degrees, pain does occur earlier but gets severe at 70. on passive more can be acheived but pain increases. internal rotation is fine but on passive ext rotation he gets pain. the pain is always around the inferior patella. on palpation he has pain 7/10 VAS along the joint line medial and lateral, on the medial side he has pain along the length of mcl. i cannot do any ligament test , acl or pcl as he is in pain with flexion, mcl and lcl cause pain with the hand pressure not the stress on the ligament, i can not do any prone tests as he can not put weight on the patella at all. he can not stand on his right leg to bear all his weight. to clear his hip i did rotation but pain again was at his knee. isometric quad and hamstring cause pain in inferior patella. what can i do to help? i thought about sinding larsen johanoson disease but his right knee seems alot worse due to the fall and i was thinking menisus, is the mri scan going to help. all i have been able to do is contrast ice and heat treatment to reduce the swelling as it has been 1 month since the fall. any info welcome