History and Physical
A 16-year-old female presents with 4 days of right lower back pain that radiates to the right groin and thigh. She describes the pain as burning and attributed to "[excessive] walking at the amusement park." She develops subsequent shortness of breath and dyspnea on exertion for 1 day and seeks medical attention. Review of 10 systems is positive for dizziness.
Her medical history is significant for possible diagnosis of inflammatory bowel disease (IBD). Medications include 6 months of oral contraceptive pills (OCPs) and occasional ibuprofen for headaches. Her diet consists of red meat.
Her family is of English, Irish, Filipino, and Japanese descent. Her parents and four siblings are healthy, although her mother has had two miscarriages.
A physical exam reveals an obese and febrile patient with mild tachycardia and intermittent mild tachypnea with appropriate blood pressure and 100% oxygen saturation on room air. Her heart and lung exam is unremarkable. The right and left thighs measure 50.5 cm and 49 cm in circumference, respectively. There is minimal edema in both distal extremities and a negative Homans' sign.