A patient with five years of lateral knee pain had several structural abnormalities on imaging. His symptoms and movement nevertheless changed during treatment. This case explores why recognising irreversible changes should not stop us looking for factors that may still improve.
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Pain below the kneecap may immediately suggest the patellar tendon. In this patient, however, the pain was worst in the morning, eased with movement and disturbed his sleep. The history and examination gradually shifted my attention towards the
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