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Rowing Against The Current: A Collegiate Athletes Struggle With Left Leg Swelling - Page #1
 

Author: Grace Erickson, BS
Co Author #1: Dr. Jill Moschelli MD, MBA, CAQ-SM, FAAFP, FACSM
Senior Editor: Kristine Karlson, MD, FAMSSM
Editor: Adam Lewno, DO

Patient Presentation:
A 19-year-old female NCAA Division 1 novice rowing athlete presented to the training room with a two-day history of left foot and leg swelling following a bike ride. Her initial swelling persisted the day after the bike ride, and she also developed pain behind her knee that was worsening. She denied a history of injury or trauma. The weekend prior to symptom onset, she spent 14 hours in a car over a 48-hour period. She denied chest pain, shortness of breath, redness, or paresthesia. She denied pain or swelling in any other location. She tried ice, elevation, and 600 milligrams of ibuprofen without relief. She denied ever having similar symptoms in the past.

History:
Past Medical History: Secondary Amenorrhea <br>Family History: None <br>Medications: Clindamycin 1% Topical Solution and Multivitamin <br>Social History: No tobacco, alcohol, or illicit drug use

Physical Exam:
Vitals: Temp: 36.7C, BP: 128/69, HR: 62, RR: 20, SpO2: 100% on Room Air <br>General Appearance: Healthy appearing, No Acute Distress <br>Lungs: Normal effort, Clear to auscultation bilaterally <br>Cardiac: Regular Rate and Rhythm, no murmurs <br>Skin: no notable lesions or abrasions <br>Neuro: Sensation intact to light touch within the lower extremities bilaterally <br>MSK: Left lower leg swelling from knee to foot. Tenderness to palpation of the popliteal fossa. Calf Circumference: (measured 2cm from tibial tuberosity) - RIGHT: 37.5cm and LEFT 40cm.

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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