title: Pulmonary embolism in a female collegiate cross-country runner presenting as nonspecific back pain.
abstract: OBJECTIVE
  The purpose of this case report is to describe a female athlete with back and right scapular pain due to pulmonary embolism.
  
  
  METHODS
  A 20-year-old female collegiate cross-country runner presented to a chiropractic clinic with pain in the right scapular area that was severe, stabbing, and worsened with respiration. She had a cough and experienced difficulty lying on her right side. She had an elevated d-dimer. Chest radiograph demonstrated pleural effusion, prompting a thoracic computed tomographic angiogram that showed a large right lower lobe embolus and pulmonary infarct.
  
  
  RESULTS
  The patient was hospitalized, prescribed anticoagulant therapy, and monitored for 6 months. She was able to return to competitive running 8 months later.
  
  
  CONCLUSIONS
  This case raises awareness of the occurrence of birth control medication for the purpose of enhanced performance in female athletes and the associated risks of using this medication for enhanced performance.
authors: Doctor of Chiropractic, Private Practice, Briarcliff Manor, NY.
authors: Warren H
authors: WH
authors: Landesberg
keywords: Athletic performance; Combined; Contraceptives; Estradiol; Oral; Venous thromboembolism