Author: Dusty Narducci, MD
Co Author #1: Jennifer Maynard MD
Co Author #2: Peter Murray MD
Editor: Joseph Chorley, MD
18 year-old male basketball player presents with intermittent limp and left calf weakness that he first noticed one year ago.
He denies recent injuries but reports a left ankle sprain within the last year for which he did not seek treatment. Denies swelling or bruising. He notes difficulty with single left heel raises but denies limitations during activities such as basketball and strength training. He admits to occasional pain 2-3/10 in the left posterior calf and ankle. He denies radicular paresthesia and numbness.
The athlete has a non- antalgic gait. Able to heel walk but toe walking was difficult on the left. He has obvious asymmetry with calf atrophy of the left. He has difficulty doing single leg heel raises on the left only. There is decreased strength 3/5 with ankle plantar flexion on the left; otherwise he has full ankle strength and range of motion. Decreased left patellar and left Achilles reflex. Negative clonus and sensation is intact. Normal back exam.
Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.