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Chronic Bilateral Exertional Lower Leg Pain And Fatigue In A 16-year-old Soccer Player - Page #3
 

Lab Studies:
CBC, CMP, UA, Lyme, Vit D, and ESR normal/negative
C-reactive protein 6.2mg/L (0.0-4.9)
TSH 131.100 uIU/mL (0.450-4.500), Free T4 0.19mg/dL (0.93-1.60), Thyroid Peroxidase (TPO) antibody 329 IU/mL (0-26)

Other Studies:
MRI calves: No stress fracture
Left Anterior Compartment Pressure Pre-Exercise: 16 mmHg
Left Anterior Compartment Pressure Post-Exercise: 50 mmHg
Right Anterior Compartment Pressure Pre-Exercise:21 mmHg
Right Anterior Compartment Pressure Post-Exercise: 48 mmHg
Left Deep Posterior Compartment Pressure Pre-Exercise: 25 mmHg
Left Deep Posterior Compartment Pressure Post-Exercise: 61 mmHg
Right Deep Posterior Compartment Pressure Pre-Exercise: 24 mmHg
Right Deep Posterior Compartment Pressure Post-Exercise: 30 mmHg
Left Lateral Compartment Pressure Pre-Exercise: 22 mmHg
Left Lateral Compartment Pressure Post-Exercise: 25 mmHg
Right Lateral Compartment Pressure Pre-Exercise: 17 mmHg
Right Lateral Compartment Pressure Post-Exercise: 26 mmHg
Left Superficial Posterior Compartment Pre-Exercise: 17 mmHg
Left Superficial Posterior Compartment Post-Exercise: 37 mmHg
Right Superficial Posterior Compartment Pre-Exercise: 13 mmHg
Right Superficial Posterior Compartment Post-Exercise: 25 mmHg

Consultations:
She was seen by the clinical director of the division of Endocrinology at CHOP and started on synthroid. Based on the duration of her fatigue and laboratory findings, she was thought to have had severe, undiagnosed hypothyroidism for approximately a year.

Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.

NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.
 

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