Noah, 12, presents with bilateral knee pain associated with playing soccer.

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<p>Noah, 12, presents with bilateral knee pain associated with playing soccer.</p><p>This has been occurring on and off for the past month, is more marked after he plays a full game, and is relieved by rest.</p><p>Noah is otherwise well, with no past or family history of note.</p><p>There is no history of injury, fever, systemic symptoms or other joint involvement.</p><p>He has been playing soccer recreationally for six years.</p><p>On examination, BMI is in normal range, though his parents note he has grown 10cm in the past few months. Vital signs are normal.</p><p>Both knees are mildly swollen, with prominent and tender tibial tubercles. Knee and hip ranges of motion are normal.</p><p>Bilateral lateral knee X-ray findings are shown.</p>

Dr Kate Kelso is a GP and medical editor at Australian Doctor.