This Case Will Make Your Skin Split

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This Case Will Make Your Skin Split - Page #1

Author: Jacob Erickson, DO Co Author #1: Andrew R. Peterson Patient Presentation: A 16-year-old male wrestler had been followed in our sports medicine clinic for chronic pre-patellar bursitis, recurrent Morel-Lavallee lesions and recurrent MRSA cellulitis. He presented with a full thickness thigh laceration sustained while pivoting on his knee during a wrestling match (a remarkably trivial trauma). The wound measured 15 x 5 cm and exposed the fascia and quadriceps muscles. <a href="CaseStudyImages/CS1Thiscasewillmakey-321.jpg" title="Case Photo #1" data-lity><b>Case Photo #1</b></a> This impressive injury, combined with his medical history, made our team suspicious for a connective tissue disorder. History: Past medical history: <br>-Anorexia nervosa (in remission) <br>-Recurrent bilateral Morel-Lavallee lesions <br>-Recurrent left knee MRSA infections and rare MRSA abscesses <br>-Right pre-patellar bursitis status post bursectomy <br>-Easy bruising <br>-Injury to right hand with 2 cm split of 3rd interdigital webspace with trivial trauma <br>-Growth hormone deficiency <br>-Hypogonadism <br>-Short stature <br>-Hypothyroidism <br>-Iron deficiency anemia Physical Exam: General: 16-year-old boy that appears that of a 14-year-old. He has a small frame, but has prominent musculature and is strikingly lean. He has bruises around both eyes with swollen cheeks. <br> <br>Skin: 15 cm laceration oriented horizontally across his left anterior thigh. 20 stitches present. <br> <br>Musculoskeletal: No effusion about the left knee. Knee flexion limited to ~20 degrees. Full extension. Strength through limited range of motion is 5/5 in knee flexion and extension. Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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