The skiers knee without swelling or instability, a difficult diagnosis: a case report
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BioMed Central
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Case report
The skiers knee without swelling or instability, a difficult diagnosis: a case report Mark E O'Donnell*1,4, Stephen A Badger1, David Campbell2, Willie Loan2 and Brendan Sinnott3 Address: 1Department of Surgery, Belfast City Hospital, Lisburn Road, Belfast BT9 7AB. Northern Ireland, UK, 2Department of Radiology, Belfast City Hospital, Lisburn Road, Belfast BT9 7AB. Northern Ireland, UK, 3Department of Emergency Medicine, Belfast City Hospital, Lisburn Road, Belfast BT9 7AB, Northern Ireland, UK and 4DSEM MFSEM(UK) MRCSEd, 42 Woodrow Gardens, Saintfield, Co Down, BT24 7WG, Northern Ireland, UK Email: Mark E O'Donnell* - [email protected]; Stephen A Badger - [email protected]; David Campbell - [email protected]; Willie Loan - [email protected]; Brendan Sinnott - [email protected] * Corresponding author
Published: 20 April 2007 Journal of Medical Case Reports 2007, 1:11
doi:10.1186/1752-1947-1-11
Received: 13 December 2006 Accepted: 20 April 2007
This article is available from: http://www.jmedicalcasereports.com/content/1/1/11 © 2007 O'Donnell et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Skiing as a recreational activity has increased exponentially in the last twenty-years. Similar to any sporting activity, participants can sustain various types of injury, which provides the emergency departments with a continuous supply of patients. The injury pattern from the slopes has also changed over this time period, due to alterations and improvements in ski equipment. An increased diversity in alpine skiing techniques, as well as snowboarding and cross-terrain disciplines has also influenced this change. We present a multi-media experience of a high-speed ski fall that caused a valgus-external rotation injury to the right knee that precluded the patient from further ski activity. There was no bruising, swelling or instability demonstrated and the patient returned to ski activities 24-hours post-injury. Although this injury appeared clinically benign initially, the patient complained of persistent pain around the right knee which was causing occupational difficulties. Following normal clinical assessment, the patient returned to work but continued to complain of persistent pain at the lateral aspect of the right knee. Magnetic Resonance Imaging (MRI) demonstrated extensive bone marrow oedema (BMO), a mild depression of the articular cortex compression with a small focus of articular cartilage disruption and microfractures of the lateral tibial plateau. The patient was treated conservatively and remains well with avoidance of impact exercises 14-months post-injury. In the presence of any high speed injury, we would stress that regardless of initial normal investigations, clinical s
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