Too Much Pain, No Gain: Rib Stress Fracture In A Cross Fit Athlete - Page #1
 

Author: Rony Skaria, MD
Co Author #1: Kevin Crawford, MD
Co Author #2: David Edwards, MD
Editor: Leigh Hanke, MD, MS

Patient Presentation:
20 year old woman with a four month history of left sided chest pain and mild left shoulder pain

History:
Experienced Cross-FitTM athlete training 6x/wk, one hour sessions.
Pain started as soreness with overhead workouts, over 2-3 weeks.
Sudden sharp pain during an overhead workout; limiting ability to do dips, pushups, pull-ups or rows.
Exacerbated by activities of daily living (reaching overhead, driving and deep inspiration).
Gradually improved with rest, but pain resumed when attempting to restart workouts 6 wks later.
No history of systemic symptoms; balanced diet, daily direct sunlight exposure
Past Medical History: oligomenorrhea, nine cycles in past year, no fractures or malignancies
No medications taken for the pain
Meds: calcium 1200mg daily and Vit D3 400 IU daily

Physical Exam:
Vitals: within normal limits
Height: 54'', Weight: 150 lbs, BMI: 25.7
General: pleasant and cooperative, muscular build
Neurologic: sensation intact to fine touch over LUE C5-T1
Skin: no rashes or vesicles
Respiratory: equal chest movement bilaterally and normal work of breathing; pain on left side with deep inspiration
Musculoskeletal: bony tenderness to palpation at mid axillary line at the left 4th rib,
worsened with anterior to posterior compression of rib cage; no palpable mass or hematoma, no bony crepitus; no winging of scapula with wall pushup; pain worsened with left lateral flexion and rotation of trunk

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, 11639 Earnshaw, Overland Park, KS 66210, (913) 327-1415.
 

© The American Medical Society for Sports Medicine
4000 W. 114th Street, Suite 100
Leawood, KS 66211
Phone: 913.327.1415


Website created by the computer geek