Differential Diagnosis
- Single most likely diagnosis
- Osgood-Schlatter disease: This is the most likely diagnosis given the presence of Osgood-Schlatter changes, edema deep to the IT band, and fluid within the pretibial bursa. The patient's symptoms and imaging findings are consistent with this condition, which is a common cause of knee pain in adolescents.
- Other Likely diagnoses
- Patellofemoral pain syndrome: The presence of mild cartilage fibrillation of the midline and medial trochlea suggests some abnormality in the patellofemoral joint, which could be contributing to the patient's symptoms. This condition is a common cause of knee pain in young athletes.
- Iliotibial (IT) band syndrome: The edema deep to the IT band could be indicative of IT band syndrome, which is a common overuse injury in runners and cyclists.
- Do Not Miss diagnoses
- Septic arthritis: Although there is no significant effusion, it is essential to consider septic arthritis in the differential diagnosis, as it can be a life-threatening condition if left untreated. The presence of edema and fluid within the pretibial bursa could be indicative of an infectious process.
- Osteosarcoma: Although rare, osteosarcoma is a malignant bone tumor that can present with knee pain and swelling. It is essential to consider this diagnosis, especially in adolescents, to ensure prompt treatment if necessary.
- Rare diagnoses
- Sinding-Larsen-Johansson syndrome: This is a rare condition that affects the patellar tendon and can cause knee pain and swelling. It is similar to Osgood-Schlatter disease but affects a different part of the knee.
- Hoffa's syndrome: This is a rare condition that affects the infrapatellar fat pad and can cause knee pain and swelling. It is often associated with trauma or overuse injuries.