Do Not Jump To Conclusions - Neck Pain After A High Ropes Course Mishap

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Do Not Jump To Conclusions - Neck Pain After A High Ropes Course Mishap - Page #1

Author: Brendan George, MD Senior Editor: Justin Mark Young, MD, FAMSSM Editor: Laura Goldberg, MD Patient Presentation: A 23-year-old female presented to a Sports Medicine clinic with right neck and shoulder pain. History: Testing a new high-ropes course for her work a week ago, a 23-year-old recreation department employee leapt from an elevated platform toward a grab-bar. She missed the bar and after falling about 6 feet, the safety harness rope became stuck under her helmet, causing the helmet chin strap to strangulate her. Coworkers recalled her arms flapping outstretched to her side with likely brief loss of consciousness; recorded video of the event support this. Case Photo #10 . After being lowered to the ground, she felt comfortable continuing the course. The following week, she sought evaluation for pain from the base of her skull into her upper posterior shoulder as well as dizziness whenever she turned left. She denied any vision changes, hearing difficulties/ tinnitus, gait ataxia, or any numbness, tingling, or weakness of her extremities. Physical Exam: Inspection: Alert, no acute distress HEENT: Abrasion and ecchymosis under the left mandible. Full range of motion of neck. Tenderness to palpation at the base of the skull, but no midline cervical tenderness. Extremities: Full range of motion of Shoulders with 5/5 strength and intact sensation. Empty can, O'Brien's, and Neer's were negative. Neuro: Alert, oriented x 3. Cranial nerves II-XII intact. Gait normal. Sensation normal in all dermatomes. Dizziness elicited with left lateral gaze. Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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