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Unique Case Of Buttock Pain In A Cyclist - Page #1
 

Author: Erica Blanchard, DO
Co Author #1: Catherine Liebman
Senior Editor: Drew Duerson, MD
Editor: Brett Bentley, MD

Patient Presentation:
Left buttock pain with a palpable nodule

History:
A 57-year-old female with no significant past medical history presented to a sports medicine clinic with left buttock pain and a palpable nodule. The nodule was located medial to the left ischial tuberosity and proximal hamstring tendons and was most noticeable when sitting on hard surfaces.

The patient reported pain and an associated snapping sensation in the region of the nodule while cycling. She was an avid cyclist and had recently completed 6- to 8-hour rides on 8 consecutive days during a cycling trip in Spain that involved substantial climbing.

Ibuprofen provided partial relief; however, changing bicycle saddles did not alleviate her symptoms. She denied numbness, tingling, radicular pain, or skin breakdown.

An ultrasound examination of the left buttock was performed 3 days after she returned from Spain.

Physical Exam:
Positive findings included a palpable ropy band of tissue measuring approximately 2.0 - 0.5 centimeters running transversely medial to the left ischial tuberosity.

The patient demonstrated full hamstring strength and full hip range of motion. There was no tenderness to palpation directly over the left ischial tuberosity or proximal hamstring tendon. No overlying skin erythema, edema, or skin breakdown was present in the left buttock region.

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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