A 13-Year-Old Boy Is Brought to the Office Due to Progressive

A 13-year-old boy is brought to the office due to progressive pain of the left knee for 3 months.  The pain initially occurred only after basketball practice but improved with rest and ibuprofen.  However, over the last several weeks, the patient has had knee pain within the first 15 minutes of practice.  Last week, the pain became so severe that he missed practice and a game.  The patient has had no fever, weight loss, or night sweats.  The pain has not caused him to awaken.  Vital signs are normal.  Physical examination reveals tenderness over the left tibial tubercle, which appears more prominent than the right.  The left knee has full range of motion and no palpable effusion.  Extension of the left knee against resistance and squatting reproduces the pain.  Which of the following is the most likely cause of this patient's knee pain?

A) Osgood-Schlatter disease
B) Patellar tendinitis
C) Patellofemoral pain
D) Prepatellar bursitis
E) Tibial osteomyelitis

Correct Answer:

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