Villafañe Federico, Holloway Nathaniel, Kettner Norman
Department of Radiology, Logan University, Chesterfield, Missouri.
Private Practice, Olive Branch, Mississippi.
J Chiropr Med. 2017 Dec;16(4):324-330. doi: 10.1016/j.jcm.2017.07.002. Epub 2017 Dec 7.
The purpose of this case report is to describe a rare location for knee osteochondritis dissecans (OCD).
A 28-year-old man presented to a chiropractic clinic with left posterolateral knee pain and swelling with joint locking after falling asleep with knees bent. A history of knee locking was reported by the patient. At presentation, he demonstrated the inability to straighten his left knee. On a pain scale of 1 to 10, he experienced level-8 stabbing pain during all knee ranges of motion with radiation to the foot. The patient was suspected of deep vein thrombosis and was sent to urgent care for evaluation.
Deep vein thrombosis was ruled out, and additional knee imaging was obtained at our clinic. Left knee radiography and diagnostic ultrasound revealed a lateral femoral trochlea osteochondral defect with an associated osteochondral fragment. Magnetic resonance imaging of the left knee was obtained for further evaluation and confirmed the diagnosis of OCD. The patient underwent surgical treatment for loose body removal and trochlear chondroplasty.
The diagnostic imaging findings in this case revealed a rare location for OCD, the lateral femoral trochlea. Symptoms of posterior knee pain require careful evaluation by clinicians and radiologists to ensure timely diagnosis and optimal treatment.
本病例报告旨在描述一例罕见部位的膝关节剥脱性骨软骨炎（OCD）。
一名28岁男性因左膝后外侧疼痛、肿胀伴屈膝入睡后关节绞锁就诊于一家整脊诊所。患者自述有膝关节绞锁病史。就诊时，他无法伸直左膝。在1至10的疼痛量表上，他在膝关节所有活动范围内均经历8级刺痛，并向足部放射。该患者被怀疑患有深静脉血栓形成，被送往紧急护理机构进行评估。
排除深静脉血栓形成后，在我们诊所进行了额外的膝关节影像学检查。左膝X线摄影和诊断性超声显示股骨外侧滑车骨软骨缺损并伴有骨软骨碎片。对左膝进行磁共振成像以进一步评估，并确诊为剥脱性骨软骨炎。患者接受了手术治疗，取出游离体并进行滑车软骨成形术。
本病例的诊断性影像学检查结果显示剥脱性骨软骨炎的一个罕见部位，即股骨外侧滑车。膝关节后方疼痛的症状需要临床医生和放射科医生仔细评估，以确保及时诊断和最佳治疗。
