NURS 6512 Week 8 Peer Response: First Peer Response

I commend Angela for her informative and comprehensive post regarding the patient, JZ, who presented with knee pain. It is indeed concerning for a 15-year-old athlete to experience bilateral knee pain after practice. Angela’s consideration of various differential diagnoses is appropriate, and I agree that conducting an MRI knee and 4-view XR would be crucial in determining the accurate diagnosis. Additionally, ordering a CBC can help identify if an infectious process is involved, while a CMP should be requested to assess the patient’s kidney function due to the potential nephrotoxicity of both creatine and Motrin. According to the research conducted by Davani-Davari, Karimzadeh, Ezzatzadegan-Jahromi, and Sagheb (2018), short-term use of creatine within recommended low doses is considered safe. However, high-dose oral creatine supplementation may lead to renal impairment as it stimulates the production of methylamine and formaldehyde. Establishing a baseline creatinine level and educating the patient about proper creatine use can help him understand the potential risks associated with these supplements.

NURS 6512 Week 8 Peer Response: First Peer Response

Nonsteroidal anti-inflammatory drugs (NSAIDs), while effective for analgesia and reducing inflammation, can also have adverse effects. Para et al. (2019) concluded that NSAID use can cause renal damage, even in younger patients without preexisting kidney disease. The inhibition of intrarenal vasodilation, decreased renal perfusion, and alterations in glomerular filtration rate (GFR) can harm even the healthiest kidneys. Although numerous potential differential diagnoses exist, patellofemoral pain syndrome (PFPS) should be considered, given the patient’s anterior knee pain. Siddiqui, Mirza-Baig, Soomro, Ishaque, and Kamal (2019) found that patellofemoral disorders, including PFPS, are commonly observed in orthopedic clinics worldwide, particularly among athletes (30%) and young athletes (26%). Examining the knee, focusing on the patella and its surrounding structures, along with X-ray imaging to rule out structural damage, is crucial when investigating PFPS. NURS 6512 Week 8 Peer Response: First Peer Response

References:

Davani-Davari, D., Karimzadeh, I., Ezzatzadegan-Jahromi, S., & Sagheb, M. M. (2018). Potential Adverse Effects of Creatine Supplement on the Kidney in Athletes and Bodybuilders. Iranian Journal of Kidney Diseases, 12(5), 253–260.

Para, I., Ciumărnean, L., Alexescu, T., Domșa, E. M., Milaciu, M. V., & Albu, A. (2019). Renal damage induced by non-steroidal anti-inflammatory drug treatment. Balneo Research Journal, (1), 03. 

Siddiqui F., Mirza-Baig, A. A., Soomro, R. R., Ishaque, F., & Kamal, A. (2019). Usage of Kinesiology Tape in the Management of Patellofemoral Pain Syndrome: A Survey among Physiotherapists in Karachi. FUUAST Journal of Biology, 9(1), 105–111.