A High School Volleyball Player With Thigh Swelling

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A High School Volleyball Player With Thigh Swelling - Page #1

Author: Rachel Chamberlain, MD Patient Presentation: 17 year old female high school volleyball player presented to ATC with medial, proximal right thigh swelling <br>First noticed shortly after volleyball season began without known injury. She complains of pain with activity. ATC measured a 5x5 cm area of swelling. ATC was concerned for a hematoma, and treated with stretching and NSAIDS, re-assessing weekly. <br> <br>After no improvement for two weeks patient was evaluated by team physician on sideline of Friday night football game <br> <br>She denied numbness or tingling, negative for fevers, chills, night sweats, adenopathy, and other areas of swelling History: PMHx: <br>migraine headaches (occasionally takes naproxen) <br>seasonal allergies (takes cetirizine) <br>Social History: Senior in high school, lives with parents, does not smoke, use drugs, drink alcohol, is not sexually active, not on oral contraceptive pills. <br>Family History: negative for pediatric cancers, significant for both grandfathers with prostate cancer, and mother with psoriasis Physical Exam: General: no distress <br>Pulm: normal work of breathing <br>Neuro: Alert, oriented x3 <br>Psych: Normal mood and affect, insight and judgment appear intact <br>Skin: no erythema, rashes, lesions <br> <br>Right thigh: <br>Right upper thigh obviously larger than left <br>Mass to right proximal medial thigh Somewhat firm, not indurated, measures 5x6 cm, no obvious fluctuance. Nontender to palpation, no pitting edema. 2+ pulses. <br>Full ROM of hip and knee without pain <br>Strength 5/5 and symmetric, no pain with strength testing <br>Normal sensation of right lower extremity Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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