845 DIFFERENTIAL DIAGNOSIS: 1. Septic Arthritis 2. Transient synovitis 3. Osteochondral/ chondral lesion 4. Primary synovial osteochondromatosis 5. Juvenile idiopathic arthritis TESTS AND RESULTS: Right knee radiographs - No bony abnormalities. Small joint effusion Right knee MRI - Large effusion and synovitis. 16mm loose body in lateral suprapatellar recess with no obvious donor site. Ligaments and menisci intact. Repeat Labs - Elevated serum CRP, ESR, WBC. Negative Lyme and Rheumatoid factor. Immediate orthopedic referral for diagnostic arthroscopy - 60cc’s of purulent fluid and multiple fibrinous exudates in suprapatellar pouch, acute inflammation of synovium, pristine art icular cartilage in all compartments, no chondral loose bodies - All specimens were negative for infection. FINAL/WORKING DIAGNOSIS: Right knee culture-negative septic arthritis with suprapatellar loose body TREATMENT AND OUTCOMES: Urgent arthroscopic irrigation and debridement with partial synovectomy and loose body removal. IV antibiotics for 4 weeks. 3110 May 29, 4:35 PM - 4:55 PM Musculoskeletal- Volleyball. Effect Of Shoe Lift In Leg Length Discrepancy Elisabetta Prandi 1 , Virginia Cesaretti 2 , Gloria Franco 3 . 1 Posturalmente, Udine, Italy. 2 Private Practice of Dentistry, Macerata, Italy. 3 University of Udine, Udine, Italy. Email: elisabetta.prandi@tin.it (No relationships reported) HISTORY: We tested a 16-year female volleyball player with a Leg Length Discrepancy(LLD). After an orthopaedic exam a structural LLD was diagnosed, left leg >1 cm. than the right, thus a shoe lift insert (SLI) of 1,50cm. was prescribed for the right leg .After an in-depth evaluation we found there is not a structural LLD but a functional discrepacy without a dysmetia of the legs, so that the SLI determined a general disruption of the motor and postural patterns likely as if the had really a scoliosis. PHYSICAL EXAMINATION: A further assessment reveled normal muscles tone. There was full active range of motion of the legs and hip, no movement painful as well as difference in strength between the legs. We observed the stomatognathic apparatus in order to evaluate the occlusion influence on the whole body arrangement .The orthodontist control showed a slight inclination of the first lower premolars. Hence the idea to study the possible correlation between occlusion and posture, defining a protocol. DIFFERENTIAL DIAGNOSIS: Alterate muscle function TEST AND RESULTS: Baropodometric load distribution: unbalance Measure level of hips : equal Measure legs : equal Total spine radiography: right convex Lumbar scoliosis Postural assessment : neck deviation, right knee rotation, different level of the shoulders Pressure mapping: left feet cable Gait analysis: normal function Meersseman test: positive FINAL/WORKING DIAGNOSIS: false short leg syndrome, proprioceptive deficits, scoliosis compensation. The occlusal framework should be analyzed and monitored over time and that is why we are developing a working protocol. TREATMENT AND OUTCOMES: Objective :Restore balance to the foot support, reduce the postural compensation established as a result of the prolonged use of higher heel, rebalancing leg strength, Was take off the shoe lift insert, as the legs were equal length, First two week: the athlete has followed a program of global active and segmental stretching for postural re-education, correction of flexibility imbalances,relaxion of contractures. third to sixth week: we add to the program proprioceptive re-education and Pilates method exercise to improve core and strength with eccentric work. After 6 weeks of treatment leg strength was the same, after 6 month the footprint was correct. 3111 May 29, 4:55 PM - 5:15 PM Medial Meniscal Tear in a Long Distance Runner Behrang Dehkordi, MD, Terry Nicola, MD, FACSM, Mark Hutchinson, MD, Winnie Mar, MD. University of Illinois at Chicago, Chicago, IL. (Sponsor: Terry Nicola MD, FACSM) Email: behrang.hd@gmail.com (No relationships reported) HISTORY: A 53 year-old male distance runner presents with a complaint of right medial knee pain for the past 3 years, Pain came on gradually and has worsened to the point where he is now unable to run more than one mile without experiencing excruciating pain that requires him to stop. He was previously an avid marathon runner who ran approximately 30-60 miles a week regularly. He reports no trauma to the knee nor any twisting or locking instances and had undergone physical therapy two years ago with minimal relief. No swelling, instability or locking of the knee. PHYSICAL EXAMINATION: Normal gait with walking and running. No pain with running a distance of 100 feet. The left knee was normal in appearance with no effusion or deformity. It exhibited full range of motion and intact strength. The right knee exhibited no effusion or deformity. There was moderate tenderness to palpation over the medial joint line. There was 5/5 strength and full range of motion on flexion and extension. The Lachmann’s test was negative. Varus/valgus tests negative. McMurray’s test negative. Patellar compression and apprehension tests negative. DIFFERENTIAL DIAGNOSIS: 1. Patello-femoral syndrome. 2. Degenerative joint disease. 3. Meniscal tear. TEST AND RESULTS: 1. Upright standing anterior-posterior and lateral views of the right knee:-Mild tri-compartmental osteoarthritis of the right knee with small supra-patellar effusion 2. MRI right knee without contrast: -Tear of the medial meniscal body and posterior horn with extruded flipped fragment of the body into the medial meniscal tibial recess. -Deep oblique fissure of the medial facet of the patella. -Mild lateral patellar subluxation and lateral tilt.