Best Practice Case Studies-Study Questions (ALL DOWNHILL FROM HERE: LATERAL KNEE PAIN IN A NEW RUNNER)

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The document outlines two study questions addressing iliotibial band syndrome (ITBS), a common cause of lateral knee pain, often affecting runners. 

<strong>Study Question #1</strong> involves a 33-year-old male runner experiencing substantial lateral knee pain after increased mileage and hill running. A key examination finding is a positive Ober's test, indicating ITBS. The correct expected finding in the history and physical exam is a positive Noble’s test, which elicits pain when the iliotibial band (ITB) is pressed against the femoral condyle near 30 degrees of flexion. Other potential findings include weak hip abductor muscles and poor lower extremity alignment, which could contribute to ITBS but are not the best answers to the question. Imaging like radiographs is generally normal and not indicated in clear cases of ITBS.

<strong>Study Question #2</strong> presents a 32-year-old female marathon trainee experiencing right lateral knee pain worsened by activities like running and bicycling. Initial management strategies include reducing activity, applying ice, and using anti-inflammatory medications, with temporary results. The next treatment step is physical therapy focusing on ITB stretching and strengthening the gluteus medius. For persistent symptoms, options like corticosteroid injections are considered. In refractory cases, surgery may be necessary.

These cases highlight the importance of recognizing ITBS in athletes, with a primary focus on physical examination findings such as Ober's and Noble's tests. Treatment typically starts conservatively, emphasizing inflammation reduction, therapeutic exercises, and, if needed, advanced interventions for difficult cases.

Meta Tag

Edition 3rd Edition

Related Case 3rd Edition, CASE 28

Topic Knee

Keywords

iliotibial band syndrome

lateral knee pain

runners

Ober's test

Noble's test

hip abductor muscles

physical therapy

corticosteroid injections

gluteus medius strengthening

marathon training

3rd Edition

3rd Edition, CASE 28

Knee