2nd September 2020

Fifteen-year-old Marcus presents to his GP due to worsening shin/knee pain

Fifteen-year-old Marcus presents to his GP due to worsening shin/knee pain. He tells the GP that the pain is felt at the top of the shin, just under the knee. The pain started slowly and has been getting progressively worse over the last 4 months. Marcus reports that it gets much worse after exercise and improves during days of rest. Marcus plays rugby most weekends and goes to the gym 4 times per week. He has always been a keen athlete, playing football when he was younger too. He has never had a traumatic injury to his knee during his sporting career. Marcus wants to be seen now as the pain is beginning to get in the way of his daily activities. 

Given the likely diagnosis which THREE of the following signs is the GP likely to elicit on examination Select THREE options only.