title: De Novo Cerebral Palsy Diagnosis in 9-Year-Old Soccer Player Presenting With Knee Pain.
abstract: A 9-year-old boy presented to our outpatient specialized sport and exercise medicine clinic complaining of a subacute onset of unilateral knee pain, after an increased level of soccer training. His knee examination was unremarkable. However, he demonstrated significant tenderness on palpation of his ipsilateral hip flexor and adductor tendons. Abnormalities in muscle tone and difficulty in relaxing and resisting the examiner properly were noted and lead to a complete neurological examination. It demonstrated multiple abnormalities such as increased tone and deep tendon reflexes, greater in lower than upper extremities, and abnormal patterning. A mild form of spastic diplegia was suspected and the patient was referred to a pediatric neurologist who confirmed our initial diagnosis. This case draws attention to the importance of maintaining a high level of suspicion for milder forms of diseases that can go unnoticed for years.
authors.affiliation: Department of Family Medicine, Western University, London, Ontario, Canada.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Ouellet
authors.forename: Tatiana
authors.initials: T
authors.lastname: Jevremovic
mesh_terms: D018771:Arthralgia / Q000209:etiology; D002547:Cerebral Palsy / Q000175:diagnosis*; D002648:Child; D006801:Humans; D007719:Knee Joint; D008297:Male; D009460:Neurologic Examination; D064797:Physical Conditioning, Human / Q000009:adverse effects; D010808:Physical Examination; D012916:Soccer; D063189:Symptom Assessment