What Lies Beneath The Bruise

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What Lies Beneath The Bruise - Page #1

Author: Ansam Hasan, MD Co Author #1: Jason Smith DO, CIC, FAOASM Co Author #2: Ahmed Mafraj, MD Senior Editor: Margaret Gibson, MD, FAMSSM Editor: Charles Litchfield, MD Patient Presentation: 14 y.o male with no significant past medical history presented to the sports medicine clinic with right medial knee pain with significant bruising for 2 days. History: The pain started during football practice where he was doing a sled drill and fell forward and hit the knee onto the ground. He had nearly immediate pain and swelling in the medial knee following the injury. The quality of the pain was described as sharp, 7/10 in severity, worse with any weight bearing activity. He reported significant swelling and bruising but did not have any painful popping or clicking, or mechanical symptoms of catching, locking or giving out. He reported it was stiff upon arising from sitting and stairs were painful and problematic. He tried Icing, compression brace and ibuprofen with mild improvement in pain. He denied any numbness, tingling, weakness, fevers, chills, or any recent weight change. There was no significant past medical history, past surgical history, family history, and no history of medication use. Physical Exam: significant swelling at the medial aspect of the distal thigh with tenderness to palpation. The range of motion was 0-90 compared to 0-135 in the contralateral side. Patellar grind, Lachman’s test, McMurray's test, varus/valgus stress test, posterior and anterior drawer are all negative. The affected lower extremity is neurovascularly intact throughout with light touch sensation intact. There was significant right lower extremity edema without specific somatic dysfunctions. Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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