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When The Ball Strikes Back - Page #1
 

Author: Wikien Hung Pinto, MD
Co Author #1: Robert Warne Fitch, MD
Senior Editor: Drew Duerson, MD
Editor: Rukayat Balogun, MD

Patient Presentation:
Left lower quadrant abdominal pain

History:
A 21-year-old Division I collegiate football player presented after football practice with left lower quadrant abdominal pain.

Approximately one hour prior to presentation, he had fallen onto his left flank onto a football and developed acute-onset, continuous, moderate, non-radiating sharp pain in the left lower quadrant. He was evaluated by the athletic trainer on the sidelines and was able to perform simple running drills. However, due to persistent pain that worsened with torso rotation and abdominal crunches, he did not return to practice.

He reported mild shortness of breath but denied nausea, vomiting, or dizziness. Prior to practice that day, he had been feeling completely healthy and denied any preceding abdominal, gastrointestinal, or genitourinary symptoms. He voided without difficulty, and after observing the appearance of his urine, he was referred to the emergency department for further evaluation.

Physical Exam:
Vital Signs: Heart rate 65 bpm; blood pressure 140/70 mmHg; respiratory rate 14 breaths/min; oxygen saturation 98% on room air.

General: No acute distress; healthy appearance.

Cardiovascular: Regular rate and rhythm. Normal S1 and S2. No murmurs or gallops.

Respiratory: Unlabored breathing with clear breath sounds throughout. No wheezes or rales.

Chest: No rib tenderness or deformity.

Abdomen: Soft, mildly tender to deep palpation over the left lower quadrant. Nondistended. No guarding or rebound tenderness.

Skin: No bruising, swelling, or lesions.

Extremities: No deformity with full range of motion.

Neurologic: Alert and oriented to person, place, time, and situation. No focal neurologic deficits. Sensation intact.

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.
 

UPCOMING EVENTS


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11/19-11/22/2026
2026 AMSSM/OHSU Introductory &/or Diagnostic/Interventional Sports US Course

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12/04-12/06/2026
2026 Advanced Team Physician Course

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4/16-4/21/2027
2027 AMSSM Annual Meeting

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