Running The Distance For A Diagnosis

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Running The Distance For A Diagnosis - Page #1

Author: Franchesca Anela Johnson, BS Co Author #1: Justin M. Young Co Author #2: Jonathan Sladky Senior Editor: Jessalynn Adam, MD Editor: Nathan Cardoos, MD Patient Presentation: 18-year-old female freshman DI cross-country and track athlete presented with left lower extremity pain, numbness and tingling for 3 weeks duration. History: The patient's symptoms began during cross-country season and progressed with training for track. For the 1500m event, symptoms typically started initially while running and then progressed from numbness and tingling to overt weakness, including foot drop. It would resolve after a few hours with rest. With runs greater than 2 miles, she had numbness in her upper hamstrings and heaviness in her lower leg. The symptoms were also present when biking. After taking a week off from running, the symptoms did not appear until the middle of her run; but when she ran daily, the symptoms appeared immediately. The patient had no history of trauma. No significant past medical history or family history. She does not smoke. She takes OTC iron and B12 supplements. Physical Exam: VS: 5'2" and 137 lbs. Temp: 37.1 C, BP: 111/70, HR: 76 bpm, RR: 18 bpm. Left leg: Her popliteal angle was 35 degrees and she had hamstring tightness. Positive Ober's test. Tightness of left quadriceps, gastrocnemius, and piriformis accompanied with tenderness to palpation. Extremities: Capillary refill Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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