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Musculoskeletal System
Step 1: View Clinicals
A 27 year old man presents with pain in the right calf for one day, and swelling of the same area since morning.
The pain started abruptly while he was playing football last evening. There was no history of trauma.
He obtained a medical consultation, at which he was prescribed analgesics and sent home. However, the pain worsened over time, and is now severe and present at rest.
His medical history is unremarkable.
A 27 year old man presents with pain in the right calf for one day, and swelling of the same area since morning.
The pain started abruptly while he was playing football last evening. There was no history of trauma.
He obtained a medical consultation, at which he was prescribed analgesics and sent home. However, the pain worsened over time, and is now severe and present at rest.
His medical history is unremarkable.
Step 2: Order Relevant Investigations
1. Renal functions
Urea: 13 mg/dL (0 - 50)
S. Creatinine: 1.0 mg/dL (0.5 - 1.5)
2. Creatine Kinase
10,800 IU/L (45 - 245)
3. Measure Compartment Pressures
Pressure in compartments of right leg:
Anterior: 30 mmHg
Lateral: 70 mmHg
Deep & Superficial Posterior: 100 mmHg
4. MRI Right Leg
There is widespread muscle edema in all four compartments. A large hematoma is noted within the body of the gastrocnemius muscle.
1. Renal functions
Urea: 13 mg/dL (0 - 50)
S. Creatinine: 1.0 mg/dL (0.5 - 1.5)
2. Creatine Kinase
10,800 IU/L (45 - 245)
3. Measure Compartment Pressures
Pressure in compartments of right leg:
Anterior: 30 mmHg
Lateral: 70 mmHg
Deep & Superficial Posterior: 100 mmHg
4. MRI Right Leg
There is widespread muscle edema in all four compartments. A large hematoma is noted within the body of the gastrocnemius muscle.
Step 3: Select Appropriate Management
1. Emergency Fasciotomy
2. IV Fluids
3. IV Antibiotics
4. NSAIDs
1. Emergency Fasciotomy
2. IV Fluids
3. IV Antibiotics
4. NSAIDs