Recurrent Shin Pain In A Runner - Page #1
 

Author: Melissa Tabor, DO
Co Author #1: Jeffrey Bytomski, DO

Patient Presentation:
22 year old Hispanic male recreational runner presents to clinic for evaluation of left lower extremity pain. He has a know history of chronic tibial stress fractures (five total, one repeat fracture), metatarsal stress fractures, mid-femoral shaft fracture, and Pycnodysostosis.

He developed anterior tibia pain after stepping in a ground depression while running 3-6 weeks prior to clinic visit. Pain is constant, worse in the morning and with walking. There are no alleviating factors. The pain does not wake him from sleep.

History:
Past Medical History: Pycnodysostosis
Past Surgical History:
Left Lower Leg Fracture Repair 1998.
Left Mid-Femoral Shaft Fracture Repair 2001.
Left Foot/Ankle Fracture Repair 2008.

Medications: Somatropin and testosterone gel (prescribed by Endocrine)

Physical Exam:
Vital Signs Stable
General: Patient is awake, alert, and oriented in no acute distress
Musculoskeletal: Left leg exam reveals a prominence distal to the mid-shaft of the tibia with mild tenderness over the prominence. He has a normal gait
Vascular: 2+ peripheral pulses bilaterally.
Neurologic: Sensation intact to light touch, DTRs 2+, gait non-antalgic

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

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