Differential diagnosis of intractable lateral knee pain with progressive symptoms: a case problem.
This case study of an active 22 year old female who sustained a traumatic incident to the right knee focuses on the differential diagnostic process. Although early subjective complaints, clinical presentation, and diagnostic testing results were commensurate with internal derangement of the knee, appropriate medical and surgical management failed to halt the progression of pain and subsequent onset of neurological symptoms. Electrodiagnostic testing conducted 10 months post initial injury produced a definitive diagnosis of an irritative lesion of the right peroneal nerve in the region of the fibular neck. A fibular tunnel release and peroneal nerve decompression was subsequently performed after which complete symptom resolution was achieved, allowing return to full functional activities.
Epler
M
M
Department of Physical Therapy, Heilman Center, Lebanon Valley College, Annville, PA 17003, USA. epler@lvc.edu
Keenan
D
D
D000200:Action Potentials / Q000502:physiology; D000328:Adult; D018771:Arthralgia / Q000209:etiology* / Q000503:physiopathology; D003937:Diagnosis, Differential; D004576:Electromyography; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000150:complications* / Q000503:physiopathology; D007719:Knee Joint; D018482:Muscle, Skeletal / Q000503:physiopathology; D009431:Neural Conduction / Q000502:physiology; D010148:Intractable Pain / Q000209:etiology* / Q000503:physiopathology; D010543:Peroneal Nerve / Q000503:physiopathology*; D020427:Peroneal Neuropathies / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery