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一名13岁男性运动员的青少年剥脱性骨软骨炎:病例报告

Juvenile Osteochondritis Dissecans in a 13-year-old male athlete: A case report.

作者信息

D'Angelo Kevin, Kim Peter, Murnaghan M Lucas

机构信息

Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Ontario ; Sports Sciences Resident, Division of Graduate Studies.

Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Ontario ; Associate Professor, Canadian Memorial Chiropractic College.

出版信息

J Can Chiropr Assoc. 2014 Dec;58(4):384-94.

Abstract

OBJECTIVE

To present the clinical management of juvenile osteochondritis dissecans (OCD) of the knee and highlight the importance of a timely diagnosis to optimize the time needed for less invasive, non-operative therapy.

CLINICAL FEATURES

A 13-year-old provincial level male soccer player presenting with recurrent anterior knee pain despite ongoing manual therapy.

INTERVENTION AND OUTCOME

A multidisciplinary, non-operative treatment approach was utilized to promote natural healing of the osteochondral lesion. The plan of management consisted of patient education, activity modification, manual therapy, passive modalities and rehabilitation, while being overseen by an orthopaedic surgeon.

CONCLUSIONS

Considering the serious consequences of misdiagnosing osteochondritis dissecans, such as the potential for future joint instability and accelerated joint degeneration, a high degree of suspicion should be considered with young individuals presenting with nonspecific, recurrent knee pain. A narrative review of the literature is provided to allow practitioners to apply current best practices to appropriately manage juvenile OCD and become more cognizant of the common knee differential diagnoses in the young athletic population.

摘要

目的

介绍青少年膝关节剥脱性骨软骨炎(OCD)的临床管理,并强调及时诊断对于优化所需的微创、非手术治疗时间的重要性。

临床特征

一名13岁的省级男子足球运动员,尽管持续接受手法治疗,但仍反复出现前膝疼痛。

干预措施与结果

采用多学科非手术治疗方法促进骨软骨损伤的自然愈合。管理计划包括患者教育、活动调整、手法治疗、被动治疗方式和康复训练,由一名骨科医生监督。

结论

考虑到误诊剥脱性骨软骨炎的严重后果,如未来关节不稳定和关节退变加速的可能性,对于出现非特异性、反复膝关节疼痛的年轻人应高度怀疑。提供文献综述,以便从业者应用当前最佳实践来妥善管理青少年OCD,并更加了解年轻运动员群体中常见的膝关节鉴别诊断。

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