Author: Frazier Keitt, DO, MS
Co Author #1: Thomas Trojian, MD
Editor: Kimberly Hornbeck, MD
Senior Editor: Kristine Karlson MD
53yo F presents for left knee and calf pain for 1 year. She first noted the pain while walking to the subway one day. She is very active and walks long distances for exercise. She notes the pain starts in the left medial calf with walking approximately 4 blocks. The pain is cramping, and usually starts as a 1-2 out of 10 on the pain scale, but then as it progresses, is eventually an 8/10. Her calf is also achy at times with a tight sensation that radiates to the knee. The pain does not improve with anti-inflammatory medication or exercise, but does somewhat improve with rest. The pain is worse with walking than running activities. Of note, she has a 5pk yr hx of smoking and desires to quit.
ACL rupture s/p 6 months of immobilization (approximately 20 years ago)
Ovarian and uterine cancer diagnosed in 2003, s/p TAH/BSO and chemo/rads
Gen: WN, WD, NAD
Cardio: 2+ pedal pulses, no peripheral edema
Skin: No rashes, small bump noted right medial gastrocnemeius
MSK left knee: no visible abnormalities, grossly non-tender, strength and AROM within normal limits
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