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Bending Beyond The Expected: Elbow Pain In A Division 1 Soccer Athlete - Page #1
 

Author: Alexander Pomerantz, MD, MPP
Co Author #1: Jim Sullivan, MD CAQSM Boston College/Mass General Brigham
Senior Editor: Kristine Karlson, MD, FAMSSM
Editor: Jeffrey Ham, DO

Patient Presentation:
18-year-old previously healthy right hand dominant female division 1 soccer athlete presented to the athletic training room with two days of worsening elbow pain and extension deficit.

History:
Patient reported atraumatic onset of antecubital fossa pain that began upon waking up. Pain is most appreciated at the end range of flexion and extension.
Patient had this pain about 6-8 times over the past 3 years, but the pain always resolved within 1-2 days. She had no prior evaluation of the pain. She has never had a traumatic injury to this elbow requiring evaluation, other than routine falls while playing soccer. No numbness, tingling, or weakness of the hand. No catching or locking symptoms.
Patient reported starting a combined oral contraceptive, for menorrhagia, approximately one week prior to presentation.

Physical Exam:
General:
Well appearing, ambulating normally
Right Elbow:
Inspection: No obvious deformity, ecchymosis, erythema
Palpation: Nontender to palpation over olecranon, medial or lateral epicondyles
Range of Motion: Active and Passive 45 to 135 degrees vs 0 to 150 degrees on Left
Strength: Full, with discomfort on resisted pronation
Neurovascularly intact

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