Objective: To discuss the case of an adolescent patient who presented to the clinic with a history of right knee pain for two years. Using evidenced-based concepts enables clinicians to ask the right questions and use the proper diagnostic tools to make an accurate diagnosis.
Clinical features: A 14-year-old male athlete presented to the clinic with right knee pain. The adolescent had been seen by his family physician and doctor of chiropractic during a two year time period. Neither practitioner had performed diagnostic procedures of the knee.
Outcome: Radiographic studies revealed a large defect of the femur’s lateral condyle consistent with advanced osteochondrosis dissecans. The patient was referred to an orthopedist who recommended surgical intervention.
Conclusion: Doctors are frequently reluctant to order X-ray or other diagnostic studies on children and adolescents, but when a pediatric patient presents with a persistent complaint and significant examination findings further diagnostic studies are warranted.
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