This Case Will Make Your Skin Split

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This Case Will Make Your Skin Split - Page #1

Author: Jacob Erickson, DO Co Author #1: Andrew R. Peterson Patient Presentation: A 16-year-old male wrestler had been followed in our sports medicine clinic for chronic pre-patellar bursitis, recurrent Morel-Lavallee lesions and recurrent MRSA cellulitis. He presented with a full thickness thigh laceration sustained while pivoting on his knee during a wrestling match (a remarkably trivial trauma). The wound measured 15 x 5 cm and exposed the fascia and quadriceps muscles. Case Photo #1 This impressive injury, combined with his medical history, made our team suspicious for a connective tissue disorder. History: Past medical history: -Anorexia nervosa (in remission) -Recurrent bilateral Morel-Lavallee lesions -Recurrent left knee MRSA infections and rare MRSA abscesses -Right pre-patellar bursitis status post bursectomy -Easy bruising -Injury to right hand with 2 cm split of 3rd interdigital webspace with trivial trauma -Growth hormone deficiency -Hypogonadism -Short stature -Hypothyroidism -Iron deficiency anemia Physical Exam: General: 16-year-old boy that appears that of a 14-year-old. He has a small frame, but has prominent musculature and is strikingly lean. He has bruises around both eyes with swollen cheeks. Skin: 15 cm laceration oriented horizontally across his left anterior thigh. 20 stitches present. Musculoskeletal: No effusion about the left knee. Knee flexion limited to ~20 degrees. Full extension. Strength through limited range of motion is 5/5 in knee flexion and extension. Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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