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A teenage boy presented to the orthopaedic clinic with bilateral knee pain after playing football earlier that day. He reported no trauma or fever, no history of any other joint involvement, or low back pain. He had been a member of the school football team for two years and actively jumped and ran during practices and games. His bilateral knee pain occurred occasionally over the past month, especially after a game, and was relieved by rest. His medical and family histories were unremarkable, with no congenital diseases.