When Bone Turns To Jello

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When Bone Turns To Jello - Page #1

Author: Adam Lyons, MD Co Author #1: Kate Temme Co Author #2: Kate Temme Co Author #3: Kate Temme Patient Presentation: A 28 year-old graduate student presented with left hip and thigh pain. History: A 28 year-old graduate student was referred by her primary care physician to the sports medicine department for left hip and thigh pain. The pain started two months prior to her presentation with a vague, sharp and achy groin pain brought on by running and relieved by rest. When she initially saw her primary care physician, she was referred to physical therapy for two weeks, noting no relief of her symptoms. She endorsed that as she was preparing for her upcoming wedding, she was under significant stress, had decreased her caloric intake, and rapidly increased her weekly running mileage. Her past medical history was significant for a femoral neck stress fracture in high school while running 35-40 miles per week. She had menarche at age 13 followed by 1-2 years of irregular menses after which she was started on oral contraceptive pills and had regular monthly menses. Her family history was significant for unspecified eating disorders. Physical Exam: Vitals: Body mass index 17, Height 5'0", Weight 40.8 kg Inspection: No obvious deformity, atrophy, edema, or ecchymosis. Palpation: Bony tenderness along the left distal femur. No other bony tenderness. Range of Motion: Full range of motion of her hips and knees. Motor: 5/5 strength in all motions Neurological: Normal reflexes and sensation bilaterally. Maneuvers: Positive FADIR (flexion adduction and internal rotation). Positive hip scour. Negative FABER (flexion, abduction and external rotation), log roll, seated slump, and straight leg raise. Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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