Knee And Calf Pain After Marathon - Page #1

Author: Matthew Bauer, DO
Editor: Young Yoon, MD

Patient Presentation:
63 year old male that presents with right knee and calf pain after his
first marathon

Patient is a 63 year old male, who recently finished his first
marathon. During his run, the patient experienced right calf cramps
near the ten mile marker of the race. Near the end of the race, the
patient noticed he started experiencing right knee pain as well.
Shortly after the marathon, the patient noticed he had significant
calf and knee swelling, from the distal 1/3 of his right leg to the
area of the popliteal fossa. After 3 days, his knee swelling resolved,
but the calf remained markedly swollen. He did continue to have knee
pain with flexion and extension, and noticed he now had "popping and
clicking" in that knee. Other than an remote history of an achilles
tear in the past, the patient has no existing medical problems.

Physical Exam:
The patient had a normal stance and arches. Patient had althered gait with left hip shift. Inspection revealed obvious soft tissue swelling surrounding the right calf. Right calf measured 21cm and left calf measured 15 cm at their greatest diameter. No skin rashes, erythema, ecchymosis was appreciated. Normal distal pulses bilaterally. Sensory function is intact bilaterally. Strength normal bilaterally, but mild pain elicited on passive range of motion of right knee and
dorsiflexion of right ankle. Left knee had normal ligamentous and meniscal testing. Ligamentous testing of the right knee revealed normal varus and valgus testing, Negative Lachman's and posterior drawer sign. Moderate pain found with McMurray's testing on the right

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