Shake It Off: Swift Recovery In A High School Dancer With Painful Chest Nodules

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Shake It Off: Swift Recovery In A High School Dancer With Painful Chest Nodules - Page #1

Author: John Bocinsky, MD Co Author #1: Tiffany Bohon, MD Senior Editor: Kevin Gray, MD Editor: Julia Bruene, MD Patient Presentation: A 14-year-old female dancer initially presented to a sports medicine clinic as a referral from her pediatrician for evaluation of sternum pain. History: For three weeks, the patient experienced anterior chest pain and swelling during her many hours of dance practice with her high school and community dance teams. She developed tender nodules over her sternum associated with erythema and inflammation. She described her pain as sharp, achy, and burning. Symptoms were worse with physical activity and dancing. Symptoms were improved with ice and rest. She had no history of breast masses, traumatic injuries, or local injections. Review of systems was negative for fevers, night sweats, weight change, numbness or tingling, or shortness of breath. Family history was positive for ulcerative colitis in her sister, and negative for breast and bone cancers in 1st degree relatives. Physical Exam: On initial exam, the patient’s vitals were unremarkable with a temperature of 36.3 C and a BMI of 18.8. Her anterior chest had multiple firm nodules, which were tender to palpation, directly over the sternum and to the right of the sternum. She was otherwise alert and oriented, in no acute distress, and had a normal cardiovascular and respiratory exam. Case Photo #1 Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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