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Differential Diagnosis for 14-year-old Female with Knee Pain

Single Most Likely Diagnosis

  • Osgood-Schlatter Disease: This condition is a common cause of knee pain in adolescents, especially those involved in sports that include running and jumping. The pain is typically located just below the knee and is exacerbated by activities that involve knee extension, matching the patient's symptoms.

Other Likely Diagnoses

  • Patellofemoral Pain Syndrome: This condition is characterized by pain around or behind the patella, often associated with activities that put stress on the knee, such as running, jumping, and climbing stairs. The pain can be exacerbated by walking and knee extension.
  • Medial Tibial Stress Syndrome (Shin Splints): Although more commonly associated with pain in the lower leg, shin splints can sometimes refer pain to the knee area. Running is a common precipitating factor.
  • Quadriceps or Patellar Tendinopathy: Overuse injuries from running can lead to inflammation of the tendons around the knee, causing pain with activities like walking and knee extension.

Do Not Miss Diagnoses

  • Osteosarcoma or Other Bone Tumors: Although rare, bone tumors can present with pain that worsens with activity. It's crucial to consider these in the differential diagnosis to ensure timely diagnosis and treatment if present.
  • Septic Arthritis: An infection within the joint can cause severe pain, especially with movement, and is a medical emergency requiring prompt diagnosis and treatment.
  • Slipped Capital Femoral Epiphysis (SCFE): More common in obese adolescents, SCFE can cause hip pain that may be referred to the knee. It's an orthopedic emergency due to the risk of avascular necrosis.

Rare Diagnoses

  • Chronic Recurrent Multifocal Osteomyelitis (CRMO): A rare condition characterized by recurring episodes of bone inflammation, which can cause pain and may mimic other conditions.
  • Kohler Disease: A rare bone disorder causing pain and swelling in the navicular bone but can sometimes be associated with referred knee pain in adolescents.
  • Sinding-Larsen-Johansson Syndrome: Similar to Osgood-Schlatter disease but affects the patellar tendon at its origin on the inferior pole of the patella, causing knee pain in adolescents involved in sports.

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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