Chronic Bilateral Thigh and Knee Discomfort in an 18-year-old Man

摘要

An 18-year-old man presented with severe, intermittent bilateral thigh and knee pain of approximately 6 months' duration. His symptoms had initially manifested as localized anterior left knee pain 2 years earlier, and he had been treated with high-dose ibuprofen and physical therapy for the presumptive diagnosis of patellofemoral syndrome. Despite attempts at nonoperative management, he had experienced progressive discomfort involving the left thigh, right knee, and right thigh. At the time of presentation, he described pain principally in the left thigh, characterized as self-remitting and without clear antecedent. He also noted long-standing night pain interfering with sleep but denied any fevers, chills, rigors, weight loss, or other constitutional symptoms. A review of systems was otherwise negative, and medical history was unremarkable.