Bilateral knee pain in a high-level gymnast.

Gymnast wrist or distal radial physeal injury is a common entity among gymnasts of all levels. It can lead to chronic pain, inability to perform, and growth issues at the wrist for these young athletes. However, less has been reported about other overuse stress injuries in this group. We present the case of a prepubescent female gymnast complaining of chronic bilateral knee pain. She was found to have bilateral distal femoral physeal stress injuries and had a similar clinical course to any gymnast diagnosed with the same injury at the wrist.

Postinjection Muscle Fibrosis from Lupron.

We describe the case of a 6.5-year-old girl with central precocious puberty (CPP), which signifies the onset of secondary sexual characteristics before the age of eight in females and the age of nine in males as a result of stimulation of the hypothalamic-pituitary-gonadal axis. Her case is likely related to her adoption, as children who are adopted internationally have much higher rates of CPP. She had left breast development at Tanner Stage 2, adult body odor, and mildly advanced bone age. In order to halt puberty and maximize adult height, she was prescribed a gonadotropin releasing hormone analog, the first line treatment for CPP. She was administered Lupron (leuprolide acetate) Depot-Ped (3 months) intramuscularly. After her second injection, she developed swelling and muscle pain at the injection site on her right thigh. She also reported an impaired ability to walk. She was diagnosed with muscle fibrosis. This is the first reported case of muscle fibrosis resulting from Lupron injection.