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Stopped Cold: The Missed Blockage That Benched A Collegiate Running Back - Page #1
 

Author: Gregory Friedberg, MD
Co Author #1: Aaron Ferro, DO
Senior Editor: Justin Mark Young, MD, FAMSSM
Editor: Julie Creech-Organ, DO

Patient Presentation:
A 19-year-old running-back presented to sports medicine clinic with two weeks of persistent right arm swelling.

History:
Two weeks prior, he was evaluated in the emergency department for a blood clot via CTA and US, both negative, and subsequently recommended to see Sports Medicine outpatient. In-clinic, the patient reported ongoing diffuse right upper extremity swelling. He denied prior occurrence or any involvement of other extremities. Review of systems was otherwise negative. Past medical history was significant only for asthma and family history notable for deep vein thrombosis in singular grandparent. No recent surgeries or known trauma. Denied alcohol, tobacco, recreational drug use, or sexual activity. No medication or supplement use.

Physical Exam:
Clinic vitals: BP 130/84, HR 73, Ht 5' 10'', Wt 187 (84.8), BMI 26.83.

Exam was significant for "swelling of the entire right arm" with ROM and strength intact. The right arm appeared dusky and taut compared to left with otherwise normal capillary refill, warm skin, and no rash. Both arms were non-tender to palpation. Pulses were intact without gross venous engorgement.

Measurements obtained for comparison: Right bicep 35.5cm (Left = 33.5cm), Right forearm 33cm (Left = 27cm). No swollen lymph nodes or masses.

Click here to continue. Challenge yourself by writing down a broad differential 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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