Recurrent Shin Pain In A Runner

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Recurrent Shin Pain In A Runner - Page #1

Author: Melissa Tabor, DO Co Author #1: Jeffrey Bytomski, DO Patient Presentation: 22 year old Hispanic male recreational runner presents to clinic for evaluation of left lower extremity pain. He has a know history of chronic tibial stress fractures (five total, one repeat fracture), metatarsal stress fractures, mid-femoral shaft fracture, and Pycnodysostosis. He developed anterior tibia pain after stepping in a ground depression while running 3-6 weeks prior to clinic visit. Pain is constant, worse in the morning and with walking. There are no alleviating factors. The pain does not wake him from sleep. History: Past Medical History: Pycnodysostosis Past Surgical History: Left Lower Leg Fracture Repair 1998. Left Mid-Femoral Shaft Fracture Repair 2001. Left Foot/Ankle Fracture Repair 2008. Medications: Somatropin and testosterone gel (prescribed by Endocrine) Physical Exam: Vital Signs Stable General: Patient is awake, alert, and oriented in no acute distress Musculoskeletal: Left leg exam reveals a prominence distal to the mid-shaft of the tibia with mild tenderness over the prominence. He has a normal gait Vascular: 2+ peripheral pulses bilaterally. Neurologic: Sensation intact to light touch, DTRs 2+, gait non-antalgic Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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