Bilateral Exertional Calf Pain - Page #1

Author: Siatta Dunbar, DO
Co Author #1: Jon M Englund, MD
Editor: Guy Nicolette, MD

Patient Presentation:
15 yo male, multi-sport athlete, with one year of bilateral exertional calf pain.

The patient has parasthesias and no pain with rest. He denies anterior or lateral calf pain and has no history of injury. During intense activity, he gets a burning and tightness in his calves. The pain subsides within 5-10 minutes after exertion. The pain is severe enough that he was unable to finish a single football game and most basketball practices and games.

Physical Exam:
No swelling of the lower legs or feet and no cyanosis are noted. Compartments were soft to palpation. No tenderness in the posterior calf musculature or posteromedial aspect of tibia bilaterally. Palpable dorsalis pedis pulse at rest, however with active plantar flexion and passive dorsiflexion there was complete loss of pulse. Neurologically intact, 2 out of 4 patellar and ankle reflexes, 5 out of 5 strength without muscle atrophy. Light touch intact bilaterally. Negative slump and straight leg raise.

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