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- W2526392502 abstract "HISTORY: A 16 year old right-hand dominant female equestrian dressage rider presents with a two year history of insidious onset bilateral forearm pain. The pain is primarily in the volar aspect of her forearms and is most severe when she is controlling the reins in a position of wrist extension. The pain is more severe in her right forearm. She had an acute exacerbation of her pain during a competition two months prior to her evaluation. At that time her pain was so severe, that she felt she was unable to safely control her horse and has been unable to continue riding. Over the previous weeks the pain has worsened so that she is unable to perform therapeutic upper extremity weight lifting or biking. She also has had pain with daily activities such as writing with a pen or turning the steering wheel of her vehicle. Her pain resolves with complete rest. She describes the pain as a tightness. She has occasionally noted swelling of the extensor compartment of her forearms. She has not noted any numbness or paresthesias in her distal extremities. PHYSICAL EXAMINATION: She had full range of motion of bilateral upper extremities and no evidence of joint effusion or soft tissue swelling. She had 5/5 strength and no pain elicited with isometric testing of elbow flexion/extension, wrist supination/pronation, and wrist flexion/extension. Sensation to fine touch was intact in the radial, ulnar, and median nerve distribution. There was minimal tenderness to palpation over the flexor-pronator muscle belly bilaterally. No tenderness over the extensor compartment. DIFFERENTIAL DIAGNOSIS: Flexor-pronator muscle tendinosis. Chronic exertional compartment syndrome, bilateral forearms. Myoadenylate deaminase deficiency. McArdle's disease (glycogen storage disease, type 5) TEST AND RESULTS: Magnetic resonance imaging, bilateral forearms: Normal bone architecture. Normal muscle architecture. Compartmental pressure testing of bilateral forearms: Right arm pre-exercise pressures: volar comparment 10 mmHg, extensor compartment 23 mmHg, mobile wad 14 mmHg. Right arm post-exercise: volar 10 mmHg, extensor 51 mmHg, mobile wad 8 mmHg. Left arm pre-exercise: volar 13 mmHg, extensor 23 mmHg, mobile wad 10 mmHg. Left arm post-exercise: volar 16 mmHg, extensor 18 mmHg, mobile wad 8 mmHg. FINAL WORKING DIAGNOSIS: Chronic exertional compartment syndrome, bilateral forearms, extensor compartment. TREATMENT AND OUTCOMES: She underwent right forearm extensor compartment and mobile wad fasciotomy. Two weeks post-operatively, she had significant improvement in her pain and was able to leisurely ride her horse. She plans to undergo fasciotomy of her left forearm." @default.
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- W2526392502 date "2006-05-01" @default.
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- W2526392502 title "Bilateral Forearm Pain in an Equestrian Rider" @default.
- W2526392502 doi "https://doi.org/10.1249/00005768-200605001-01609" @default.
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