Differential Diagnosis for a 13-year-old Boy with Knee Pain
- Single most likely diagnosis
- Osgood-Schlatter disease: This condition is characterized by pain, swelling, and tenderness below the knee, typically at the tibial tuberosity, which is exactly where the patient's pain is localized. It often occurs in adolescents during growth spurts, especially in those who participate in sports involving running or jumping, making it highly likely given the patient's recent increase in basketball activity.
- Other Likely diagnoses
- Sprain: Given the patient's involvement in basketball, a sprain could be a possible diagnosis, especially if the pain is related to a specific injury or overuse. However, the specific location of the pain and the exacerbation with jumping suggest Osgood-Schlatter disease more strongly.
- Bursitis: Bursitis could cause knee pain and swelling, but it typically involves more significant swelling and might not specifically exacerbate with jumping in the same way as Osgood-Schlatter disease.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Slipped Capital Femoral Epiphysis (SCFE): Although the pain is localized to the knee, SCFE can sometimes present with referred pain to the knee. It is a serious condition that requires prompt diagnosis and treatment to prevent long-term damage, making it crucial not to miss.
- Juvenile Rheumatoid Arthritis (JRA): While less likely given the localized nature of the pain and the absence of systemic symptoms or joint effusion, JRA can present in various ways and is important to consider to ensure early diagnosis and treatment.
- Rare diagnoses
- Tumor or cystic lesions: These would be rare causes of knee pain in an adolescent but could potentially present with localized pain and swelling. Advanced imaging might be considered if the diagnosis remains unclear after initial evaluation and treatment for more common conditions.