This Case Will Make Your Skin Split - Page #1

Author: Jacob Erickson, DO
Co Author #1: Andrew R. Peterson

Patient Presentation:
A 16-year-old male wrestler had been followed in our sports medicine clinic for chronic pre-patellar bursitis, recurrent Morel-Lavallee lesions and recurrent MRSA cellulitis. He presented with a full thickness thigh laceration sustained while pivoting on his knee during a wrestling match (a remarkably trivial trauma). The wound measured 15 x 5 cm and exposed the fascia and quadriceps muscles. Case Photo #1 This impressive injury, combined with his medical history, made our team suspicious for a connective tissue disorder.

Past medical history:
-Anorexia nervosa (in remission)
-Recurrent bilateral Morel-Lavallee lesions
-Recurrent left knee MRSA infections and rare MRSA abscesses
-Right pre-patellar bursitis status post bursectomy
-Easy bruising
-Injury to right hand with 2 cm split of 3rd interdigital webspace with trivial trauma
-Growth hormone deficiency
-Short stature
-Iron deficiency anemia

Physical Exam:
General: 16-year-old boy that appears that of a 14-year-old. He has a small frame, but has prominent musculature and is strikingly lean. He has bruises around both eyes with swollen cheeks.

Skin: 15 cm laceration oriented horizontally across his left anterior thigh. 20 stitches present.

Musculoskeletal: No effusion about the left knee. Knee flexion limited to ~20 degrees. Full extension. Strength through limited range of motion is 5/5 in knee flexion and extension.

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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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Phone: 913.327.1415

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