Author: William Berrigan, M.D.
Co Author #1: Robert Bunning, M.D.
Co Author #2: Robert Bunning, M.D.
Co Author #3: Robert Bunning, M.D.
Editor: Yaowen Hu, MD, MBA
A 23 year old professional women's soccer player presented with acute onset left sided back pain after getting kneed in the back. She immediately fell to the ground, was unable to get up secondary to pain, and was taken off the field in a stretcher. Upon initial evaluation, she was responsive, complaining of excruciating left sided non-radiating flank and back pain exacerbated with movement of the legs. She denies loss of consciousness, neck pain, numbness or paresthesias in the upper and lower extremities, bowel or bladder dysfunction.
She had no significant past medical history, including neuromuscular or inflammatory disease, and denied drinking, smoking, or illicit drugs.
She was alert and answering questions. No visible ecchymosis was appreciated. There was no midline bony tenderness of the spine. There was left lumbar paraspinal tenderness and left sided flank tenderness. Manual muscle testing was 5/5 i n the bilateral upper extremities, 4/5 throughout the left lower extremity and 4+/5 throughout the right lower extremity, limited to pain. Sensation was intact in the upper and lower extremities. Abdominal exam was benign.
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