Musculoskeletal Examination

Knee pain in an adolescent is usually the result of trauma. Partial avulsion of the tibial tubercle associated with a painful swelling in that area is called Osgood-Schlatter disease. This common condition is seen more frequently in pubertal boys and is usually self-limited. Knee pain may also be referred from the hip and result from a slipped capital femoral epiphysis (SCFE). Movement of the hip into external rotation as the leg is flexed at knee and hip is very suggestive of SCFE. SCFE is fairly common during the pubertal growth spurt and is especially common in obese adolescents.

Scoliosis often progresses rapidly during the pubertal growth spurt.

If the adolescent is seeking medical clearance for competitive sports, it is worth performing a comprehensive musculoskeletal screening examination to detect, among other things, incompletely rehabilitated sports injuries. One such screening examination was well described by Foster and colleagues (2006).

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