clinical quiz

Oman Medical Journal [2017], Vol. 32, No. 2: 170–171

Severe Knee Pain in a 22-year-old Woman After Trauma

Maximilian Andreas Storz* and Arne Oliver Lücke

Department of Radiology, Aarhus University Hospital, Aarhus, Denmark

article info

Online:

A healthy 22-year-old woman presented to the Emergency Department of Aarhus University Hospital with pain after she fell on her right knee. After taking the medical history, a thorough clinical examination was performed. A patellar trauma was suspected and consequently X-ray images of the affected knee were obtained. These included anterior-posterior and lateral views [Figure 1 and 2] as well as a skyline projection [Figure 3].

Questions

  1. What is the most likely diagnosis?

    a.Patella fracture.

    b.Sinding-Larsen-Johansson-Syndrome.

    c.Accessory ossification center.

    d.Bone tumor, most likely osteosarcoma.

    e.Osgood-Schlatter disease (OSD).

  2. What is the usual initial treatment for this condition?

    a.Single or repetitive corticosteroid injection.

    b.Chemotherapy and radiation therapy.

    c.Surgical treatment, including removal of the ossicle fragmentation.

    d.Rest, ice, and nonsteroidal anti-inflammatory drugs.

    e.Complete reduction in activity for at least one week.

Answers to the quiz, and the full article, can be found online at www.omjournal.org.

CME Credit

You may earn CME credits by reading the quiz and answering the questions online. Answers for the quiz can be found online (www.omjournal.org). CME credits are awarded by Oman Medical Specialty Board by the Continued Professional Development Department.

Figure 1: Anterior-posterior view of the right knee. Neither a fracture nor a dislocation is visible in this projection. The joint spaces and the soft tissues were normal.

Figure 2: The lateral view of the tibial tuberosity reveals an ununited free ossicle (red arrow).

Figure 3: The skyline projection of the right knee does not reveal a patellar displacement or fractures. The patella was well positioned.