An Unusual Hematuria In College Football Player - Page #1

Author: Shawn Skarpnes, MD
Co Author #1: Shawn Skarpnes, M.D.
Co Author #2: Brian Harrell, M.D., CAQSM
Editor: Jason Mogonye, MD

Patient Presentation:
18-year-old otherwise healthy male presented with right flank pain and hematuria for 24 hours

A college football wide receiver noticed frank blood in his urine 1 day following an evening practice in which he sustained blunt trauma to his right torso from the helmet of a defensive player. The patient reported moderate localized right flank pain immediately following the impact; however, it was the blood-tinged urine that alerted the athlete to seek further evaluation in the ER.

Physical Exam:
ER Vital signs: BP 142/77 HR 60 RR 18 Temp 97.9 Sat 100% on RA
GEN: Alert and oriented young African American male of athletic build in mild distress due to right flank pain.
HEENT: Moist mucous membranes with clear oropharynx.
RESP: Non-labored breathing with lungs clear-to-auscultation bilaterally.
CVS: Heart rate and rhythm regular with palpable distal pulses.
GI: Abdomen soft, non-distended, non-tender, with normal bowel sounds. No hepatosplenomegaly.
MSK: Right costovertebral angle tenderness to palpation. Rib cage and spine non-tender to palpation without deformity. Motor function intact with FROM.
GU: Normal external genitalia, no meatal erosions or lesions, no urethral blood or discharge.
SKIN: Warm, dry, intact, no edema, rashes, or bruising.

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