Kevin D'Angelo1, Peter Kim2, M Lucas Murnaghan3. 1. Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Ontario ; Sports Sciences Resident, Division of Graduate Studies. 2. Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Ontario ; Associate Professor, Canadian Memorial Chiropractic College. 3. Staff Physician, Division of Orthopaedic Surgery, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario ; Assistant Professor, Department of Surgery, University of Toronto.
Abstract
OBJECTIVE: To present the clinical management of juvenile osteochondritis dissecans (OCD) of the knee and highlight the importance of a timely diagnosis to optimize the time needed for less invasive, non-operative therapy. CLINICAL FEATURES: A 13-year-old provincial level male soccer player presenting with recurrent anterior knee pain despite ongoing manual therapy. INTERVENTION AND OUTCOME: A multidisciplinary, non-operative treatment approach was utilized to promote natural healing of the osteochondral lesion. The plan of management consisted of patient education, activity modification, manual therapy, passive modalities and rehabilitation, while being overseen by an orthopaedic surgeon. CONCLUSIONS: Considering the serious consequences of misdiagnosing osteochondritis dissecans, such as the potential for future joint instability and accelerated joint degeneration, a high degree of suspicion should be considered with young individuals presenting with nonspecific, recurrent knee pain. A narrative review of the literature is provided to allow practitioners to apply current best practices to appropriately manage juvenile OCD and become more cognizant of the common knee differential diagnoses in the young athletic population.
OBJECTIVE: To present the clinical management of juvenile osteochondritis dissecans (OCD) of the knee and highlight the importance of a timely diagnosis to optimize the time needed for less invasive, non-operative therapy. CLINICAL FEATURES: A 13-year-old provincial level male soccer player presenting with recurrent anterior knee pain despite ongoing manual therapy. INTERVENTION AND OUTCOME: A multidisciplinary, non-operative treatment approach was utilized to promote natural healing of the osteochondral lesion. The plan of management consisted of patient education, activity modification, manual therapy, passive modalities and rehabilitation, while being overseen by an orthopaedic surgeon. CONCLUSIONS: Considering the serious consequences of misdiagnosing osteochondritis dissecans, such as the potential for future joint instability and accelerated joint degeneration, a high degree of suspicion should be considered with young individuals presenting with nonspecific, recurrent knee pain. A narrative review of the literature is provided to allow practitioners to apply current best practices to appropriately manage juvenile OCD and become more cognizant of the common knee differential diagnoses in the young athletic population.
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