Q. What should be next step in a child complaining pain in one of his knee (left) for last three months and could not recall history of any significant trauma and near normal knee radiograph as shown below?
a. Radiographs of both knees every week
b. Pain medication and assurance
c. Plaster for three weeks
d. Examination of hip
e. No treatment required
f. MRI of knee
Answer -
d
In any patient complaining of unexplained knee pain, it is mandatory to evaluate hip region for any problem as the knee pain might be referred or related to hip pathology as anterior be of obturator nerve supplies to the knee and part of hip.
Radiograph of knee or MRI of knee may also be right option but only after assessing hip as we might require radiograph/ MRI of hip and not knee in many cases.
Assurance and no treatment are not option as they are only prescribed if required and after ruling out any significant disorders of either hip or knee.
The pelvic radiograph ( below) of the same patient showed hip joint decreased space suggesting underlying pathology in ipsilateral ( left side) hip joint highlighting the importance of this question and its answer.
a. Radiographs of both knees every week
b. Pain medication and assurance
c. Plaster for three weeks
d. Examination of hip
e. No treatment required
f. MRI of knee
Answer -
d
In any patient complaining of unexplained knee pain, it is mandatory to evaluate hip region for any problem as the knee pain might be referred or related to hip pathology as anterior be of obturator nerve supplies to the knee and part of hip.
Radiograph of knee or MRI of knee may also be right option but only after assessing hip as we might require radiograph/ MRI of hip and not knee in many cases.
Assurance and no treatment are not option as they are only prescribed if required and after ruling out any significant disorders of either hip or knee.
The pelvic radiograph ( below) of the same patient showed hip joint decreased space suggesting underlying pathology in ipsilateral ( left side) hip joint highlighting the importance of this question and its answer.
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