An Unusual Hematuria In College Football Player

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An Unusual Hematuria In College Football Player - Page #1

Author: Shawn Skarpnes, MD Co Author #1: Shawn Skarpnes, M.D. Co Author #2: Brian Harrell, M.D., CAQSM Patient Presentation: 18-year-old otherwise healthy male presented with right flank pain and hematuria for 24 hours History: A college football wide receiver noticed frank blood in his urine 1 day following an evening practice in which he sustained blunt trauma to his right torso from the helmet of a defensive player. The patient reported moderate localized right flank pain immediately following the impact; however, it was the blood-tinged urine that alerted the athlete to seek further evaluation in the ER. Physical Exam: ER Vital signs: BP 142/77 HR 60 RR 18 Temp 97.9 Sat 100% on RA GEN: Alert and oriented young African American male of athletic build in mild distress due to right flank pain. HEENT: Moist mucous membranes with clear oropharynx. RESP: Non-labored breathing with lungs clear-to-auscultation bilaterally. CVS: Heart rate and rhythm regular with palpable distal pulses. GI: Abdomen soft, non-distended, non-tender, with normal bowel sounds. No hepatosplenomegaly. MSK: Right costovertebral angle tenderness to palpation. Rib cage and spine non-tender to palpation without deformity. Motor function intact with FROM. GU: Normal external genitalia, no meatal erosions or lesions, no urethral blood or discharge. SKIN: Warm, dry, intact, no edema, rashes, or bruising. Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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