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J Am Acad Nurse Pract. 2008 Nov;20(11):563-6. doi: 10.1111/j.1745-7599.2008.00355.x.

An unusual cause of knee pain discovered at a nurse practitioner clinic.

Author information

  • 1Gulf Coast Medical Clinic, Robertsdale, Alabama 36617, USA. alan_heins@yahoo.com

Abstract

PURPOSE:

To describe an interesting and instructive case of knee pain from nurse practitioner (NP) practice and discuss the epidemiology, pathophysiology, clinical evaluation, and treatment of osteosarcoma.

DATA SOURCES:

Findings from the history, physical examination, diagnostic testing, and follow-up of the case of an 18-year-old male who first presented with nontraumatic, diffuse left knee pain of 2.5-month duration.

CONCLUSIONS:

At follow-up, after a trial of conservative treatment, a lesion suspicious for osteosarcoma was seen in the proximal tibia. Osteosarcoma is a rare but dangerous cause of chronic extremity pain, especially in children and adolescents.

IMPLICATIONS FOR PRACTICE:

NPs must consider malignant bone tumors in the differential diagnosis of traumatic and nontraumatic extremity pain of extended duration, especially in children and adolescents. Thorough, persistent follow-up on recommended tests and referrals is necessary to ensure that important findings are not missed. The care of uninsured patients requires particular attention to cost concerns and access issues.

PMID:
19128340
[PubMed - indexed for MEDLINE]
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