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Too Much Pain, No Gain: Rib Stress Fracture In A Cross Fit Athlete - Page #1
 

Author: Rony Skaria, MD
Co Author #1: Kevin Crawford, MD
Co Author #2: David Edwards, MD

Patient Presentation:
20 year old woman with a four month history of left sided chest pain and mild left shoulder pain

History:
Experienced Cross-FitTM athlete training 6x/wk, one hour sessions. <br>Pain started as soreness with overhead workouts, over 2-3 weeks. <br>Sudden sharp pain during an overhead workout; limiting ability to do dips, pushups, pull-ups or rows. <br>Exacerbated by activities of daily living (reaching overhead, driving and deep inspiration). <br>Gradually improved with rest, but pain resumed when attempting to restart workouts 6 wks later. <br>No history of systemic symptoms; balanced diet, daily direct sunlight exposure <br>Past Medical History: oligomenorrhea, nine cycles in past year, no fractures or malignancies <br>No medications taken for the pain <br>Meds: calcium 1200mg daily and Vit D3 400 IU daily

Physical Exam:
Vitals: within normal limits <br>Height: 5’4'', Weight: 150 lbs, BMI: 25.7 <br>General: pleasant and cooperative, muscular build <br>Neurologic: sensation intact to fine touch over LUE C5-T1 <br>Skin: no rashes or vesicles <br>Respiratory: equal chest movement bilaterally and normal work of breathing; pain on left side with deep inspiration <br>Musculoskeletal: bony tenderness to palpation at mid axillary line at the left 4th rib, <br>worsened with anterior to posterior compression of rib cage; no palpable mass or hematoma, no bony crepitus; no winging of scapula with wall pushup; pain worsened with left lateral flexion and rotation of trunk

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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Phone: 913.327.1415


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