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Excerpt
HISTORY - A 19-year-old intramural football player presented to the clinic with a one day history of painless hematuria. While playing quarterback in a contact football game, he sustained numerous hits to the thorax and back region. He had no back or abdominal pain after the football game. After an evening of drinking, he noted gross hematuria on three occasions during the night. He presented to the clinic in the afternoon after more episodes of gross hematuria. He described the urine as dark red and denied any back pain or dysuria or previous episodes of hematuria.
PHYSICAL EXAMINATION - Examination 24 hours after the incident revealed no CVA tenderness or flank pain. Patient had tenderness on his right side at ribs seven through nine along the midaxillary line. There was no abdominal pain, tenderness, guarding or palpable masses. He had no suprapubic tenderness or other pelvic findings. The patient's musculoskeletal and neurological examination was unremarkable with normal range of motion of the spine and lower extremities. Patient's blood pressure was similar to other clinic visits.
