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- W2955001640 abstract "Lower Leg Pain – Field Hockey HISTORY: A 20-year-old collegiate field hockey player 1 year, 2 months out from bilateral anterior/lateral/deep posterior compartment fasciotomies for chronic exertional compartment syndrome, recurrence of pain along her bilateral medial legs and medial/plantar foot numbness. Worsening over previous 6 months. Pain is daily, constant. Had MRI/MRA arterial duplex performed at onset of symptoms and was told it was negative. No improvement with neuropathic pain medication, physical therapy, hydrodissection. PHYSICAL EXAMINATION: Examination revealed healed surgical incisions. Mild scar hypertrophy along medial incisions with moderate tenderness to palpation. Full knee/ankle ROM. Pain reproduced with resisted ankle plantar flexion after 30 seconds, numbness along medial/plantar aspect of foot in tibial nerve distribution. Easily palpable dorsalis pedis/posterior tibialis pulses. DIFFERENTIAL DIAGNOSIS: 1. Recurrent chronic exertional compartment syndrome 2. Saphenous nerve compression neuropathy 3. Popliteal Artery Entrapment Syndrome TEST AND RESULTS: 1. Repeating compartment pressure testing: normal compartment pressures 2. EMG/NCS: normal without evidence of compression neuropathy 3. MRA (PRISMA 3T) study: forced plantarflexion demonstrates bilateral compression of the popliteal arteries at the popliteal fossa between the medial and lateral heads of the gastrocnemius muscle. FINAL/WORKING DIAGNOSIS: Popliteal Artery Entrapment Syndrome TREATMENT AND OUTCOMES: 1. Referred to plastic surgery colleagues. 2. Underwent bilateral popliteal artery releases 1 year, 8 months after index surgery. 3. Improvement of both pain and numbness along medial aspect of foot. 4. Last seen at 3 months post-operatively. Full, painless ROM. No pain with resisted plantarflexion. Normal sensation. Anticipate return to sport over the next 6 weeks." @default.
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- W2955001640 date "2019-06-01" @default.
- W2955001640 modified "2023-09-27" @default.
- W2955001640 title "Lower Extremity Pain - Field Hockey" @default.
- W2955001640 doi "https://doi.org/10.1249/01.mss.0000561453.29615.cf" @default.
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