Page 124 - JSOM Fall 2019

An Ongoing Series

ReSTRAiN Yourself Before Diagnosing Strain

Katarzyna (Kasia) Hampton, MD ; Livia Van Humbeeck, MS-1 2
1

uring the last 2 weeks on a deployment to a moun- 1. What finding is obviously notable in Figure 1?
tainous high-altitude terrain, one of your teammates 2. What are the common risk factors for this condition, and
Ddecides to intensify his training in preparation of an ul- what is the risk profile of our patient?
tramarathon. It is his third visit in 10 days for worsening right
leg pain. On the initial 2 visits, you diagnosed musculoskeletal Join us at SOFsono.org for further case discussion.
strain and advised the use of nonsteroidal anti-inflammatory
drugs with activity modification.

During this visit, you note the following vital signs: heart rate, Keywords: ultrasonography; high-altitude terrain; musculo-
50 bpm; blood pressure, 115/65mmHg; respirations, 18/min; skeletal strain
SpO , 99% on room air, and temperature, 36.7°C (98°F).
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Your clinical examination is notable only for tenderness to
palpation of the anterior right upper leg. You decide to ob-
tain an ultrasound. As you scan through the proximal anterior
thigh, you take note of a finding depicted in Figure 1.

FIGURE 1 Proximal anterior thigh on the right.

Correspondence to sofsono.org@gmail.com
1 Dr Hampton is an emergency physician and a volunteer SME ultrasound instructor for the military medical community. She is practicing at
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the US Army Landstuhl Regional Medical Center, Germany. Ms Van Humbeeck is a medical student at the Jagiellonian University in Cracow,
Poland.
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