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Scholarly Works (2 results)

  • Article
  • Peer Reviewed
Clinical Practice and Cases in Emergency Medicine, Volume 3, Issue 1 (2019)
A 38-year-old male presented with left calf pain after a fall while skiing. Physical examination revealed tenderness over the gastrocnemius with a palpable mass and pain with resisted plantar flexion. Point-of care-ultrasound (POCUS) of the gastrocnemius was consistent with a muscle rupture, and we made a diagnosis of tennis leg. The patient was instructed to rest for two weeks, followed by a home rehabilitation program, and he was able to return to his normal activities. Here we present a case of tennis leg quickly and accurately diagnosed with POCUS, negating the need for additional advanced imaging.
    Cover page: Point-of-care Ultrasound Diagnosis of Tennis LegCreative Commons 'BY' version 4.0 license
    • Article
    • Peer Reviewed
    Clinical Practice and Cases in Emergency Medicine, Volume 4, Issue 4 (2020)

    Introduction: The clinical presentation of pulmonary embolism (PE) is often associated with classic vital instability such as tachycardia, hypoxia, and tachypnea. This critical diagnosis is often less likely if a patient is negative by Pulmonary Embolism Rule-Out Criteria (PERC) standards with a low pre-test probability of disease. Caution must be used when evaluating elite athletes with the PERC rule due to low resting heart rate and certain risk factors, which are inherent to athletics.

    Case Report: We report the case of a 20-year-old male Division 1 collegiate athlete with pleuritic chest pain diagnosed with PE despite being PERC negative. His presenting heart rate (HR) of 79 beats per minute was correctly determined to be tachycardic relative to his resting HR of 47-60 beats per minute. Despite his PERC negative status, PE was found after an elevated D-dimer and subsequent computed tomography angiography.

    Conclusion: Special consideration should be used when evaluating elite athletes for PE, as their resting physiology may differ from the general population. Additionally, certain risk factors for thromboembolic disease are inherent in competitive athletics and should be considered during an initial risk assessment. The presented patient was successfully treated with oral anticoagulation for three months and was able to return to play.

      Cover page: Case Report: A Near Miss of Pulmonary Embolism in a Division 1 Collegiate Basketball PlayerCreative Commons 'BY' version 4.0 license
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