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Chronic Bilateral Exertional Lower Leg Pain And Fatigue In A 16-year-old Soccer Player - Page #3
 

Lab Studies:
CBC, CMP, UA, Lyme, Vit D, and ESR normal/negative <br>C-reactive protein 6.2mg/L (0.0-4.9) <br>TSH 131.100 uIU/mL (0.450-4.500), Free T4 0.19mg/dL (0.93-1.60), Thyroid Peroxidase (TPO) antibody 329 IU/mL (0-26)

Other Studies:
MRI calves: No stress fracture <br>Left Anterior Compartment Pressure Pre-Exercise: 16 mmHg <br>Left Anterior Compartment Pressure Post-Exercise: 50 mmHg <br>Right Anterior Compartment Pressure Pre-Exercise:21 mmHg <br>Right Anterior Compartment Pressure Post-Exercise: 48 mmHg <br>Left Deep Posterior Compartment Pressure Pre-Exercise: 25 mmHg <br>Left Deep Posterior Compartment Pressure Post-Exercise: 61 mmHg <br>Right Deep Posterior Compartment Pressure Pre-Exercise: 24 mmHg <br>Right Deep Posterior Compartment Pressure Post-Exercise: 30 mmHg <br>Left Lateral Compartment Pressure Pre-Exercise: 22 mmHg <br>Left Lateral Compartment Pressure Post-Exercise: 25 mmHg <br>Right Lateral Compartment Pressure Pre-Exercise: 17 mmHg <br>Right Lateral Compartment Pressure Post-Exercise: 26 mmHg <br>Left Superficial Posterior Compartment Pre-Exercise: 17 mmHg <br>Left Superficial Posterior Compartment Post-Exercise: 37 mmHg <br>Right Superficial Posterior Compartment Pre-Exercise: 13 mmHg <br>Right Superficial Posterior Compartment Post-Exercise: 25 mmHg

Consultations:
She was seen by the clinical director of the division of Endocrinology at CHOP and started on synthroid. Based on the duration of her fatigue and laboratory findings, she was thought to have had severe, undiagnosed hypothyroidism for approximately a year.

Click here to continue. Challenge yourself by writing down a revised, working 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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