Unilateral Lower Leg Weakness In A High School Football Player

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Unilateral Lower Leg Weakness In A High School Football Player - Page #3

Lab Studies: No laboratory studies were ordered. Other Studies: The first right leg MRI Case Photo #1 Case Photo #2 , ordered by the original orthopedist, revealed a 9 cm heterogenous mass within the peroneus longus muscle which may involve/produce mass effect inside the proximal lateral leg. Differential diagnosis includes nerve sheath tumors and soft tissue sarcomas. Biopsy may be considered for further evaluation. A repeat MRI ordered in follow up in the Sports Medicine clinic Case Photo #3 Case Photo #4 revealed decreased diameter and signal intensity of the abnormal signal within the peroneus longus muscle. The signal also appeared more homogenous and consistent with a resolving hematoma with associated contusion and partial thickness tear of the peroneus longus. An MRI of the lumbar spine was normal. Electromyography revealed a severe right common peroneal nerve mononeuropathy at the knee characterized by early denervation, no firing motor units in the tibialis anterior and extensor hallucis longus, and few firing motor units in the peroneus longus. Peroneal nerve sensory and motor responses were absent. Right sural nerve sensory response was absent. No evidence of a lower extremity radiculopathy was found. Consultations: No consultations were requested. Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.		Back
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