Steve Beck: Marathon Collapse, Patellar Dislocation, Compartment Syndrome, and Kidney Failure

Steve first appears to have a dislocated kneecap after passing out during a marathon. The later leg swelling, absent pulses, fasciotomies, and kidney failure point to a dangerous muscle-pressure and toxin-clearance problem.

Steve Beck is documented in the episode medical notes with diagnosis: Right patella dislocation, Severe dehydration, Compartment syndrome, Kidney failure. Treatment listed for the case includes Reduction, Bracing, Fluids, Fasciotomy, Dialysis. *Diagnosis: **Right patella dislocation **Severe dehydration **Compartment syndrome **Kidney failure *Doctors: **Callie Torres (orthopedic surgery resident) **Richard Webber (general surgeon) **Cristina Yang (surgical intern) *Treatment: **Reduction **Bracing **Fluids **Fasciotomy **Dialysis Steve, 32, passed out while running a marathon and dislocated his knee. In the ER, Callie reduced his knee and told Cristina to brace it and run post-reduction films. And Callie told him to skip the race next time he had a cold. He was given fluids when labs revealed severe dehydration. Cristina said his knee looked fine and said he might need some physical therapy. However, he said that his leg hurt and when she examined them, she saw extreme swelling in both legs. He had no pulse in either leg, so they had to do bilateral fasciotomies to relieve the pressure. He also showed signs of a recent heart attack. His kidneys were also failing. Callie put together that the aspirin had accelerated his symptoms. Richard took him to an OR to insert a dialysis catheter to filter the toxins out of his body.

Marathon Collapse, Patellar Dislocation, Compartment Syndrome, and Rhabdomyolysis Risk

A real team would reassess the knee after reduction, check pulses and neurologic function, monitor swelling and pain, order labs for dehydration, muscle injury, kidney function, and electrolytes, and escalate quickly if compartment syndrome is suspected.

Management may include patellar reduction, bracing, fluids, repeated neurovascular checks, urgent fasciotomy for compartment syndrome, electrolyte correction, and dialysis access when kidney failure or toxin clearance becomes severe.