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Back Pain In A Wide Receiver - Page #1
 

Author: Justin Mullner, MD

Patient Presentation:
A 15 year-old Caucasian male football wide receiver presented with progressively worsening left-sided, non-radiating low back pain that began during football camp 1 month prior.

History:
The patient denied any specific injury or trauma. The pain was sharp, 8/10 worse with cutting and pivoting motions during football practice and occasionally present at rest. He was still playing football but the pain had increased significantly over the last 4 days. Ibuprofen and ice helped relieve the pain. <br>ROS: He denies fever, weight loss, paresthesias or neurologic symptoms. PMH: spina bifida occulta; L5 pars fracture 2 years prior.

Physical Exam:
Vitals: afebrile, BP 100/58, pulse 66. <br>Back: <br>No visible deformities or scoliosis. <br>Tenderness to palpation over the left lower back just above the waistline. <br>Full ROM with flexion and extension of the back. Pain with hyperextension of the back. Pain with lateral bending to both sides as well as with rotation of the torso. <br>Positive stork test bilaterally, worse on the right. <br>Lower extermities: Tight hamstrings. <br>Patellar and Achilles tendon reflexes are 2+. Normal sensation in bilateral. Strength 5/5. Dorsalis pedis and posterior tibial pulses normal. Negative straight leg raise.

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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