Author: Aaron Campbell, MD, MHS
Editor: Kathryn Ackerman, MD, MPH
Acutely painful left quadriceps, out of proportion with exam, loss of function, and weakness
21 year old previously healthy male, college football linebacker, presents with sudden onset extreme thigh pain during practice. Two weeks prior during a game, the patient sustained direct trauma to the thigh by another playerâ€™s knee, resulting in a painful contusion. Initially, he was able to walk, and over the next two weeks, his thigh remained painful, but he continued to play at full capacity during games and practice. Then, during a practice he noted increased tightness and pain to his thigh, which later progressed to extreme pain and tightness, preventing him from activity.
Moderate distress due to pain. The left thigh has marked swelling over the antero-lateral aspect, as compared to the right. It is tense, warm, and painful to touch. He is unable to perform a straight leg raise. The tibialis anterior, gastoc-soleus, and ankle extensors/flexors are intact. Distal neurovascular structures are intact throughout.
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