A Stressful Softball Season

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A Stressful Softball Season - Page #1

Author: Roberto Medina, MD Co Author #1: Roberto Medina, MD Co Author #2: Scott Rand, MD Co Author #3: Christian Schupp, MD Senior Editor: Kristine Karlson, MD, FAMSSM Editor: Sam Hwu, MD Patient Presentation: Acute left lateral forearm pain. History: A 17-year-old female club softball pitcher presented with a one-week history of left lateral forearm pain that started after a period of excessive pitching. Initially she only had pain when pitching, but then developed lateral forearm pain that steadily worsened to a point she had pain lifting light objects. Her pain was described as excruciating, sharp, 9/10, non-radiating, and constant. Her pain was associated with weakness. She denied paresthesia, discoloration or edema. Treatment with ice and oral analgesics provided minimal relief. She had 3 meals a day and had normal menses. She reported taking 5,000 IU of Vitamin D daily. Physical Exam: The patient was a healthy young female with a BMI of 32 and vital signs within normal limits. She presented with no acute distress. The patient's left forearm was within normal alignment and had no deformities. She had local swelling and tenderness over the mid-portion of the lateral forearm. The left elbow and wrist were within normal range of motion in all planes and strength. She had pain with resisted pronation more than supination. Other special tests were negative. The patient had normal sensation to light touch in the median, radial, and ulnar nerve distributions. The patient's capillary refill was intact and radial pulse 2+ Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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