Thrown For A Curveball; A Baseball Pitcher's Unique Injury

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Thrown For A Curveball; A Baseball Pitcher's Unique Injury - Page #3

Lab Studies: Laboratory evaluation was performed given the prolonged knee pain and leading diagnosis of bilateral tibial stress fractures. Comprehensive metabolic panel showed a normal blood urea nitrogen (BUN), creatinine, electrolytes, serum protein, and calcium. Vitamin D level was normal. Thyroid and Parathyroid hormone testing were normal. Complete blood count revealed a normal hemoglobin at 13.5 and hematocrit of 44%. Iron panel revealed a total serum iron of 68 (low) and a ferritin of 17.4 (low). Other Studies: Initial Knee radiographs revealed mild bilateral fragmented apophyses at the tibial tuberosity. Repeat knee radiographs 6 weeks later Case Photo #1 displayed a new horizontal bony opacity near the proximal tibial shaft bilaterally. Magnetic resonance imaging without contrast of the bilateral knees Case Photo #2 further displayed bilateral incomplete stress fractures across the proximal tibial metaphysis with associated marrow edema and soft tissue edema. Consultations: No consultations were performed. Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.		Back
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