Differential Diagnosis
- Single most likely diagnosis
- Osgood-Schlatter disease: This is the most likely diagnosis given the presence of Osgood-Schlatter changes, edema within the pretibial bursa, and mild adjacent soft tissue edema within the distal patellar tendon. The patient's age and symptoms are also consistent with this diagnosis.
- Other Likely diagnoses
- Patellofemoral pain syndrome: The presence of mild cartilage fibrillation of the midline and medial trochlea, as well as the patient's age and sex, make this a possible diagnosis. However, the lack of significant effusion and the presence of Osgood-Schlatter changes make it less likely.
- Iliotibial (IT) band syndrome: The small amount of edema deep to the IT band could suggest IT band syndrome, but the lack of other symptoms such as lateral knee pain and snapping or clicking of the IT band make it less likely.
- Do Not Miss diagnoses
- Septic arthritis: Although the patient does not have a significant effusion, it is essential to consider septic arthritis due to the potential for severe consequences if left untreated. However, the lack of other symptoms such as fever, redness, and warmth make it less likely.
- Tumor: A tumor, such as a osteosarcoma or Ewing's sarcoma, could present with similar symptoms, including edema and bursitis. Although rare, it is crucial to consider this possibility to avoid delayed diagnosis.
- Rare diagnoses
- Sinding-Larsen-Johansson syndrome: This is a rare condition that affects the distal patellar tendon and can cause symptoms similar to Osgood-Schlatter disease. However, it is less common and typically affects younger patients.
- Hoffa's disease: This is a rare condition that affects the infrapatellar fat pad and can cause symptoms similar to those presented in the case. However, it is less common and typically affects older patients.