Leg Pain, More Than Just A Strain

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Leg Pain, More Than Just A Strain - Page #1

Author: Jimmy Gonzales, MD Co Author #1: Laura Schnettgoecke, ATC Co Author #2: J. Field Scovell, MD Co Author #3: Jennifer Mitchell, MD Patient Presentation: 20 year old Division 1 female soccer athlete presents with several days of left groin pain during spring soccer season. She recently had a road trip with the team which was 9 hours each way. Pain started the day after the road trip. Pain was in the groin and medial portion of the left leg. She tried ibuprofen and acetaminophen with no relief. She complained of swelling of the left lower extremity. History: Past Medical: Dysmenorrhea, constipation, hip impingement Past Surgical: none Family Hx: none Social Hx: single, denies alcohol, tobacco, illicit drugs Medications: Oral contraceptive 0.3/30 PO daily which was started 4 months prior for dysmenorrhea Physical Exam: Vital Signs: Ht 5'4", Wt 139 lbs, HR 81, BP 138/80 Gen: Thin, athletic, female, no apparent distress Skin: Warm and dry Head: Normocephalic atraumatic, ocular movements intact Neck: supple, no thyromegaly Lungs: clear to auscultation bilaterally, no wheezing, no shortness of breath Heart: regular rate and rhythm, no murmur Abdomen: soft, non-tender, non-distended, normoactive bowel sounds Neuro: no focal deficits Extremities: Left thigh with significant swelling although LLE was soft and compressible. Tender to palpation over medial adductor compartment and left groin. Normal passive range of motion but pain with resisted knee extension. Dorsalis pedis and posterior tibial pulse were not palpated on the left and were easily palpated on the right. Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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