Author: Jacob Erickson, DO
Patient Presentation:
A 31-year-old runner was admitted to the hospital with abdominal pain and dark red colored urine for two days. Three days prior he had done the "ab ripper" portion of the P90X workout for 45 minutes. He denied any trauma, fever or chills.
History:
PMH:
-Depression
-Headaches
Past Surgical:
-None
Allergies:
-None
Medications:
-Celexa 20 mg
Social:
-PhD Scientist
-Recreational runner
-Lifetime non-smoker
-Social alcohol
Family history:
-DM type II
-Hypertension
Physical Exam:
General: Well appearing, no acute distress
Abdomen: No erythema, ecchymosis, or swelling noted. Moderate bilateral lower quadrant tenderness with deep palpation. No rebound, guarding or peritoneal signs. No masses. No hepatosplenomegaly.
Muskuloskeletal: Tenderness with palpation over the medial proximal thighs bilaterally. There is pain with activation of the rectus abdominal muscles. Tenderness with palpation of the proximal rectus femori and sartorius bilaterally. Pain with resisted hip flexion and knee extension bilaterally. Power was 5/5 in all lower extremity muscles tested.
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