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What Could Cause Severe Knee Injury And Knee Pain In A 14-year-old Gymnast After Reviewing From Bursitis?

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Posted on Thu, 6 May 2021
Question: MY 14 YO DAUGHTER INJURIED HER LEFT GREAT TOE IN GYMNASTICS IN SEPTEMBER 2017. ORTHO/XRAY SAID IT WAS BURSITIS BUT WITHIN A WEEK INTENSE PAIN STARTED RADIATING UP HER LEG AND HER LEG WAS COLD TO THE TOUCH. ER DR DIAGNOSED HER WITH REGIONAL SYMPATHETIC DYSTROPHY/CRPA AND PRESCRIBED ANTI-SEIZURE MEDS, PHYSICAL THEORAPY, AND CRUTCHES. A MONTH LATER THE RADIATING PAIN SUBSIDED BUT HER KNEE HURT. XRAY AND MRI SHOWED A PARTIAL ACL TEAR. AFTER 4 MONTHS OF PT KNEE PAIN CONTINUED THOUGH ACL WAS HEALED. ITS NOW 9 MONTHS SINCE THE TOE/KNEE INJURY AND THE KNEE PAIN CONTINUES. RHEUMATOLOGIST RULED OUT RA BUT DRAINED KNEE AND INJECTED CORTOZONE IN KNEE TODAY. TONIGHT LOWER LEG IS COLD TO THE TOUCH AGAIN AND PAIN REMAINS. SHE IS RUSSIAN/TANZANIAN - WE ADOPTED HER AT 8 MONTHS OLD SO NO FAMILY HISTORY IS AVAILABLE. HER BODY TENDS TO OVER REACT TO MINOR INJURIES AND IN MOST CASES THE INTENSE SYMPTOMS GO AWAY IN A FEW DAYS AND SHE'S BACK TO NORMAL BUT NOT SO WITH THE KNEE. ANY IDEAS WHAT IS GOING ON. ANY GUIDANCE IS GREATLY APPRECIATED.
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Answered by Dr. Neeraj Kumar (46 minutes later)
Brief Answer:
Improvement may occur with intraarticular steroid

Detailed Answer:
Hello,
I have gone through your question and understand your concern.
The knee ligament injury may have occurred during the initial injury and was unnoticed initially.
Persistence of knee pain can occur sometimes due to injured and repaired ligament.
Intraarticular steroid may help in decreasing inflammation and pain.
Coldness in feet may be due to autonomic function abnormalities. You can get a arterial Doppler study of lower limb to rule out any arterial occlusion.
Hope you found the answer helpful.
Do get back to me for further information.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by : Dr. Remy Koshy
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Answered by
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Dr. Neeraj Kumar

Neurologist

Practicing since :2006

Answered : 2259 Questions

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What Could Cause Severe Knee Injury And Knee Pain In A 14-year-old Gymnast After Reviewing From Bursitis?

Brief Answer: Improvement may occur with intraarticular steroid Detailed Answer: Hello, I have gone through your question and understand your concern. The knee ligament injury may have occurred during the initial injury and was unnoticed initially. Persistence of knee pain can occur sometimes due to injured and repaired ligament. Intraarticular steroid may help in decreasing inflammation and pain. Coldness in feet may be due to autonomic function abnormalities. You can get a arterial Doppler study of lower limb to rule out any arterial occlusion. Hope you found the answer helpful. Do get back to me for further information. Regards Dr N Kumar Neurologist