Knee Conditions

Beatriz Cunill-De Sautu; Rani S. Gereige

doi:10.1542/pir.35-9-359

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Beatriz Cunill-De Sautu, MD*
Rani S. Gereige, MD, MPH*

^*Miami Children’s Hospital, Miami, FL

AUTHOR DISCLOSURE
Drs Cunill-De Sautu and Gereige have disclosed no financial relationships relevant to this article. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.

Abbreviations:

ACL:: anterior cruciate ligament
LCL:: lateral collateral ligament
MCL:: medial collateral ligament
MRI:: magnetic resonance imaging
NSAID:: nonsteroidal anti-inflammatory drug
PCL:: posterior cruciate ligament
PFPS:: patellofemoral pain syndrome

Practice Gaps

With the increase in sports participation by children and teens, knee injuries are commonly encountered in the primary care setting. Pediatric clinicians must be able to accurately diagnose, appropriately image, and judiciously refer young athletes who present with knee conditions.
Clinicians should be aware of the difference in the presentation and management of knee injuries, both acute and chronic, in skeletally mature vs immature athletes.

Objectives

After completing this article, readers should be able to:

Differentiate varying conditions that may present with the common symptom of knee pain.
Identify physical findings that would confirm the diagnosis of common knee problems in children and adolescents.
Appropriately manage common knee overuse conditions.
Know the criteria for orthopedic consultation for a knee injury.

Introduction

Pediatric and adolescent sports injuries have increased in the past 20 years because of several factors, including 1. an increase in the annual number of participants in organized sports, including 30 million to 35 million children (1)(2)(3) and 25 million high school students in the United States; (2) 2. an increase in the intensity of training and competition; and 3. participation on multiple teams in a given season or concentration on a single-sport activity at an early age. (1)(4) Approximately 1.5% of athletes, particularly boys between 10 and 14 years of age, will sustain injuries during recreational activities. (5) Sports-related injuries result in 2.5 million emergency department visits annually by adolescent athletes. (2) Pediatricians and emergency department physicians are often the first contacts for these individuals and must have a sound background to accurately diagnose a given injury and to assist the athlete in …