Meniscal lesion or patellar tendinopathy? A case report of an adolescent soccer player with knee pain.

BACKGROUND: Injuries to the meniscus are particularly prevalent in soccer players, with an incidence of 0.448 injuries per 1000 hours of playing. However, in the adolescent soccer player population, it has been reported that up to 63% of asymptomatic knees may demonstrate horizontal or oblique tears on MRI. These results may negatively influence clinical decision-making and plan of management for adolescent soccer players with knee problems.

CASE PRESENTATION: A case of a 15-year-old soccer player is presented after having been diagnosed by his family physician with a left lateral meniscus tear as per MRI, following a 10-week period of anterior knee pain. He presented to a chiropractor for a second opinion before consulting with the orthopedic surgeon.

MANAGEMENT AND OUTCOME: Recommendations for progressive rehabilitation owing to the lack of clinical evidence for meniscal abnormality were made. A primary diagnosis of left patellar tendinopathy was determined and after a 6-week comprehensive rehabilitation program, the patient made a complete recovery.

SUMMARY: A thorough history, physical examination, and understanding of the patient's injury mechanism are suggested before confirming/refuting suspicions of meniscal abnormalities via MRI. This will help to inform better clinical decision-making as well as decrease the occurrence of unnecessary imaging.