Thursday-Abstracts

Official Journal of the American College of Sports Medicine
TTE-Normal LV function w/ estimated LV EF 60%. No obvious segmental wall
motion abnormalities. Mild tricuspid regurgitation. Pulmonary artery pressure
48mmHg consistent with pulmonary hypertension. 3+(Moderate) mitral regurgitation.
Prominent prolapse of the posterior mitral valve. Normal intra-atrial and intraventricular
septum.
FINaL WOrKING dIaGNOsIs:
Persistent/Progressive Mitral Valve Prolapse/Regurgitation
TrEaTMENT aNd OuTCOMEs:
1) Referred to cardiology for further evaluation
2) TEE completed- progressive MV prolapse/regurgitation with the development of
pulmonary HTN, the player underwent MV annuloplasty.
3) Repeat TTE 5 weeks status-post annuloplasty revealed normalization of PA
pressures, resolved MV prolapse, but persistent mild-to-moderate MR.
4) Player was not cleared for participation. He was asked to return for
re-evaluation 12 weeks after surgery to allow for ring stabilization.
1823 Board #10 May 30, 5:45 PM - 6:45 PM
Proximal Thigh swelling Precipitates Numbness, Tingling
and swelling In a 38yo stunt rider
Ryan S. Wagner. Avita health System, Bucyrus, OH.
hIsTOry: 38yo male presents to the clinic in mid-August 2012 with a complaint
of a large hematoma over his proximal right thigh and focal swelling over his right
patella after wrecking his motorcycle during a stunt-riding event on four weeks prior.
He was diagnosed with hematoma and pre-patellar bursitis. The pre-patellar bursa
was aspirated under ultrasound guidance and fully drained with prescription for
prophylactic antibiotics. The bursitis resolved.
Two months later he returned with persistent swelling to the proximal, anterolateral
right thigh. He had developed constant numbness and tingling over the anterolateral
aspect of his thigh progressing to just superior to the knee accompanied by severe
burning pain.
PhysICaL EXaMINaTION:
Inspection: Discrete, fluctuant mass overlying the proximal anterolateral thigh, 10cm
distal to inguinal crease, 10x7cm in dimension. No associated erythema, ecchymosis or
wound. Otherwise unremarkable.
Palpation: Burning pain is provoked with palpation of the medial third of the mass.
Otherwise no specific tenderness.
Neurologic: Normal strength and reflexes, diminished sensation in the distribution of
the anterior branch of the Lateral Femoral Cutaneous Nerve (LCFN).
Special maneuvers: +Tinel’s over the medial third of the fluctuant mass.
PhysICaL EXaMINaTION: 1) Seroma, organized hematoma, soft tissue mass; 2)
HNP/Radiculitis, meralgia paresthetica.
TEsT aNd rEsuLTs: Diagnostic US of the lesion demonstrated a fluid filled
mass with delineation between the muscular fascia and the sub-cutaneous tissue. A
structure is visualized traversing the lumen located in the medial third of the lesion
in the anatomic location of the LCFN, tented. The lesion was aspirated and 90mL of
serosanguinous fluid was removed.
FINaL WOrKING dIaGNOsIs: Morel-Lavallee lesion causing Meralgia
Paresthetica
TrEaTMENT aNd OuTCOMEs: The patient continued a compression wrap for
Vol. 45 No. 5 Supplement S353
3 days after which the lesion recurred. Pain returned 4-5 days later. He requested a
second aspiration. This was performed with 60mL of serosanguinous fluid removed
and 100mg of Doxycycline reconstituted in 10mL of sterile water was injected back
into the lesion for sclerodesis. He was instructed on continuing the compression wrap
for 3-4 weeks. At 2 weeks the lesion has not yet recurred.
Abstracts were prepared by the authors and printed as submitted.
Thursday, May 30, 2013