Waiting For The Other Foot To Drop - Page #1

Author: Leinaala Song, MD
Co Author #1: Christopher Kurahashi, MD
Co Author #2: Gale Prentiss, MD
Co Author #3: Benjamin Chun, MD
Senior Editor: Marc Hilgers, MD, PhD, FAMSSM
Editor: Richard Uribe, MD, MPH

Patient Presentation:
A 28 year old female soccer player presented for evaluation of left foot drop. Four weeks prior, during a soccer match, she suffered an acute left knee collision injury with valgus mechanism and was diagnosed with a grade 2 medial collateral ligament (MCL) tear. She was initially treated conservatively with bracing, ice and physical therapy. However, one day after switching knee braces, she developed acute weakness with left foot dorsiflexion and numbness over the left anterior shin.

Past medical history revealed a prior right brachial plexus neuropathy following a shoulder injury with incomplete recovery. On review of systems she endorsed frequent paresthesias to her arms and legs when sleeping in the wrong position or crossing her legs for too long.

Family history was significant for father and paternal grandmother with similar frequent paresthesias, although they all continued to play competitive sports throughout adulthood.

Physical Exam:
General Appearance: Young healthy female in no apparent distress.

Left knee:
Range of motion: 0-130 degrees.
Negative Lachman.
Negative anterior/posterior drawer.
2+ valgus laxity at 30 degrees.
No valgus laxity at 0 degrees.
Negative varus laxity at 0/30 degrees.

Cranial Nerve II-XII intact.
Motor strength 5/5 except 4/5 right hand grip and left foot dorsiflexion/plantar flexion.
Subjective decreased sensation to light touch along the lateral aspect of the left lower leg. Intact to vibratory and temperature sensation.
Normal finger to nose and rapid alternating movement.
Negative Romberg test and normal gait.

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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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4000 W. 114th Street, Suite 100
Leawood, KS 66211
Phone: 913.327.1415

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