Leg Weakness After Heading A Soccer Ball

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Leg Weakness After Heading A Soccer Ball - Page #1

Author: Kaitlin Minnehan, MD Co Author #1: Heather Gillespie, MD Senior Editor: Jessalynn Adam, MD Editor: Nathan Cardoos, MD Patient Presentation: 37 year-old male recreational soccer player presented with left hip and leg pain. History: A 37 year-old male with a past medical history of renal transplant, hyperlipidemia and hypertension developed left hip and leg pain that was initially appreciated after heading a soccer ball during a game. He landed squarely on both feet and had no knee pain, popping or giving way. Pain resolved within a few minutes. Two weeks later he presented to the sports medicine clinic with episodic muscle spasms and pain in the left leg, with radiation of pain to his abdomen and shoulder. He also reported a right-sided headache. A week later he developed worsening left leg weakness along with new left arm weakness and presented to the Emergency Department. Medications include tacrolimus, prednisone, atorvastatin and metoprolol. Physical Exam: Exam as performed in the sports medicine clinic. General: no acute distress, alert and oriented x3, no cognitive deficits MSK: Left Hip: Non-antalgic gait. Difficulty walking on toes and heels of the left foot. Non-tender throughout. Normal pain-free ROM. Neuro: CN II-XII intact. Strength 4+/5 with left hip flexion, knee flexion, knee extension, ankle dorsiflexion and ankle plantarflexion. Strength 5/5 with all equivalent testing on the right. Sensation intact to light touch in all 4 extremities. Patellar and achilles reflexes 3+ on left and 2+ on 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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