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A 31 Year-old Runner With Abdominal Pain And Red Colored Urine - Page #1
 

Author: Jacob Erickson, DO

Patient Presentation:
A 31-year-old runner was admitted to the hospital with abdominal pain and dark red colored urine for two days. Three days prior he had done the "ab ripper" portion of the P90X workout for 45 minutes. He denied any trauma, fever or chills.

History:
PMH: <br>-Depression <br>-Headaches <br>Past Surgical: <br>-None <br>Allergies: <br>-None <br>Medications: <br>-Celexa 20 mg <br>Social: <br>-PhD Scientist <br>-Recreational runner <br>-Lifetime non-smoker <br>-Social alcohol <br>Family history: <br>-DM type II <br>-Hypertension

Physical Exam:
General: Well appearing, no acute distress <br>Abdomen: No erythema, ecchymosis, or swelling noted. Moderate bilateral lower quadrant tenderness with deep palpation. No rebound, guarding or peritoneal signs. No masses. No hepatosplenomegaly. <br>Muskuloskeletal: Tenderness with palpation over the medial proximal thighs bilaterally. There is pain with activation of the rectus abdominal muscles. Tenderness with palpation of the proximal rectus femori and sartorius bilaterally. Pain with resisted hip flexion and knee extension bilaterally. Power was 5/5 in all lower extremity muscles tested.

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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