What is the Cause in this Case of Lower Extremity Weakness
By: Ava Clavijo, Sabrina Fordham and Andrew Jakiel
Abstract
The goal of this study is to identify the cause of progressive lower extremity weakness where the pain is chronic in nature. In this case, the patient suffered a right hip avulsion fracture in 2014 during a football injury. He has been in chronic pain for ten years with no known cause or diagnosis. The patient has pursued a diagnosis from doctors of several specialties, including neurology, rheumatology, neuropathology, cardiology, and others. This has resulted in numerous tests with no conclusive results. The goal of this study was to identify the most likely causes. A combination of library research and lab results acquired from the patient voluntarily were used to determine the pathologies reviewed. After analyzing the blood tests, medical imaging results, and a muscle biopsy report, there were signs of inflammation, marrow edema, and joint inflammation in the knees and sacroiliac joints. Pathologies considered included deep vein thrombosis, motor neuron disease, extraforaminal entrapment, mitochondrial myopathy, and others. Pathologies were determined to be less likely if test results contradicted the signs of the disease. The research shows that the patient's signs and symptoms align with those of complex regional pain syndrome. Complex regional pain syndrome is a diagnosis of exclusion with qualifications such as an inciting event with disproportionate pain and duration, allodynia, temperature asymmetry, and decreased range of motion. This data was used to create a plan of hypothetical therapeutic interventions including physical therapy, aquatic therapy, and hippotherapy.
Language: English
Published on: Mar 20, 2025
Published by: University of North Georgia
In partnership with: Paradigm Publishing Services
© 2025 Ava Clavijo, Sabrina Fordham, Andrew Jakiel, published by University of North Georgia
This work is licensed under the Creative Commons Attribution 4.0 License.