Ultrasound Evaluation and Surgical Excision of a Fabella Causing Peroneal Neuropathy in a Track Athlete

BACKGROUND: There are multiple causes of posterior knee pain and radicular symptoms. A symptomatic fabella is a rare cause but should be considered in the differential diagnosis. PURPOSE: Physicians should consider a symptomatic fabella as a diagnosis when common treatments for posterior knee pain have not alleviated the symptoms. STUDY DESIGN: Case report. METHODS: Review of clinical documentations of an orthopedist, physiatrist, physical therapist, 2 primary care sports medicine physicians, and the surgical report of an orthopedist. RESULTS: It took time and resources including several referrals and imaging modalities to make a final diagnosis. CONCLUSION: Symptomatic fabellae are an uncommon finding but should be considered in the differential diagnosis with an athlete with posterior knee pain. CLINICAL RELEVANCE: Considerable time and resources were used to ultimately diagnose and treat a NCAA Division 1 athlete. Surgical excision was required of a sesamoid bone that is present in 30% of individuals.