Rosh Review EM Scholar Monthly Question

A 24-year-old woman presents to the emergency department with persistent severe pain in her right thigh following a direct blow during a soccer match 2 weeks ago. She is participating in an important tournament, so she has been attempting to continue playing. However, she reports difficulty and pain with walking and feels a hard lump in the affected area. Physical exam reveals tenderness, swelling, and restricted range of motion in the right thigh. Based on the most likely diagnosis, which of the following will likely be found on imaging?

1. A femur fracture
2. A high-riding patella
3. A noncompressible right femoral vein with decreased color flow on Doppler
4. An avulsion fracture of the anterolateral tibial plateau
5. Calcification and bone formation within the thigh muscle

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References

1. Abraham MK, Bond MC. Femur and hip injuries. In: Walls RM, Hockberger RS, Gausche-Hill M, et al., eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 10th ed. Elsevier; 2023:(Ch) 47.
2. Von Fange TJ. Quadriceps muscle and tendon injuries. Post TW, ed. UpToDate. UpToDate Inc. Accessed July 7, 2023. https://www.uptodate.com/contents/quadriceps-muscle-and-tendon-injuries

Post Peer Reviewed By: Salim R. Rezaie, MD (Twitter: @srrezaie)