USMLE Forum Archives - USMLE Step 2 CK - Thigh pain.
Thigh pain.
laparotomy - 01-28-08 15:17
A 54 year old male presents to your emergency department with a 10 day history of right thigh pain which he suffered following a kick by a horse. He is in excruciating pain not relieved by analgesia. You order an xray and find no bony injury.
What is your next step in management?
What is your diagnosis?
laparotomy - 01-28-08 15:17
A 54 year old male presents to your emergency department with a 10 day history of right thigh pain which he suffered following a kick by a horse. He is in excruciating pain not relieved by analgesia. You order an xray and find no bony injury.
What is your next step in management?
What is your diagnosis?
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#1
Re: Thigh pain. radhamesramos - 01-28-08 20:45 Looks a lot like malingering too but I would check for a nerve injury...probably a sensitive branch of the femoral. Gevie him either Gabapentin or pregabaline... hope it is right
#2
Re: Thigh pain.
laparotomy - 01-29-08 03:28 
posted by radhamesramos on 01-28-08 20:45
Looks a lot like malingering too but I would check for a nerve injury...probably a sensitive branch of the femoral. Gevie him either Gabapentin or pregabaline... hope it is right
Looks a lot like malingering too but I would check for a nerve injury...probably a sensitive branch of the femoral. Gevie him either Gabapentin or pregabaline... hope it is right
What you are thinking of is "Meralgia paraesthetica" and the nerve compressed is the lateral cutanous nerve of the thigh. The therapy for that is a nerve block.
This patient actually had a compartment syndrome and his symptoms settled following a fasciotomy.
#3
Re: Thigh pain. radhamesramos - 01-29-08 09:17 Thanks! Compartment syndrome was my second guess, but I didn't dare to say...I thought about the meralgia first because I've seen cases like that...but I guess a compartment syndrome is more acute and should be thought first...good one
#7
Re: Thigh pain. laparotomy - 02-02-08 07:41 posted by funtonic on 02-01-08 15:33
for muscle lysis
for muscle lysis
And if it is elevated then what is your conclusion? Rhabdomyelisis?
#8
Re: Thigh pain. radhamesramos - 02-03-08 19:28 That won't change the therapy...a fasciotomy is an emergent intervention, so not delays
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