Friday, June 6, 2008

LOTR Sign

A 30 year old woman comes in complaining of knee pain after a Lord of the Rings marathon. She gets anterior knee pain after long periods of sitting. The same pain also happens when she climbs hills, runs, and walks on uneven surfaces. She sometimes complains of a noisy knee. She is not an athlete.

Challenge: This does not seem like a whole lot of information, but the most likely diagnosis can be made based on this simple history. What is it?

2 comments:

Alex said...

went on vacation and missed the last couple cases.. prolly would have guessed a couple.

i think it's just a run of the mill mini-fracture. but the bump sounds like torn meniscus

Craig said...

LOTR Sign

This is patello-femoral syndrome, retro- or peri-patellar pain exacerbated by repetitious or prolonged flexion. The cause is unknown, most likely multifactorial. The typical presentation is described here; the “movie-goer” or “theater” sign is pain after prolonged sitting. Therapy is usually conservative.

Source: UpToDate.