a swollen tibial tuberosity

tender on palpitation over tib tuberosity

common presentation in skeletal immature athletic population (F 8-12, M 12-15)

stress activities such as jumping and prolonged running during adolescence

pain following rest post exercise

Response to a noxious stressor (i.e. trauma, infection, surgery etc.)

Immune system attacks joint

Pain

Swelling

Potential joint damage

E.g. Rheumatoid arthritis

Medial knee pain at insertion point of sartorial, semitendinosis, gracillis

Overuse/repetition injury of flexion and adduction

Tight hamstrings

Trauma/acute injury to the site

Common in obese Middle Ages women because of the wider pelvis and the different forces going through the knee

Swelling and pain

Pain increases with exercise

Tenderness

No specific presentation with vague knee pain and swelling

Stabbing knee pain - exacerbated with activity

Knee swells simultaneously with the onset of the pain. The entire knee is irritated because of the loose pieces, and it responds by producing extra synovial fluid in the knee joint

Stiffness and feeling of instability

Mechanical symptoms include: knee feels like it is giving way, clicking, knee is locked - due to the fragments in the knee

OCD can exist for years without symptoms, but suddenly cause discomfort due heavy straining of the joint

Late OCD findings might include quadriceps muscle atrophy and gait deviations

overuse injury, involving repeated strenuous weigh baring activities (marching, running, jogging)

common in track and field athletes, endurance, gymnaists, dancers and people just starting exercise.

35% military recruits

Diagnosis

exercise induced pain

reduces with rest

tibial stress fracture

compartment syndrome

vascular etiologies

Stages

bone strain stress response

stress reaction (localised pain on bone)

stress fracture