Case 3

Patient basic data: Peter P., male, dob 01.01.2001, (19 y/o), non-smoking, no treated hypertension, or diabetes.

Symptom: Pain in left upper thigh

Fictional diagnosis: Delayed onset of muscle soreness

History: Yesterday the patient had gone on a long hike with friends in the mountains – for the first time in his life. The friends had walked about 15 km with each a 10 kg backpack on paved paths in hilly terrain. The patient sustained no trauma. He found the uphill climbs very tiring. His other sports activities have been limited to school sports and computer games. Movement is now hardly possible, he complains of strong pain (VAS 7) in the quadriceps muscles and the buttocks, and displays a strong limping gait. After a quiet night, he now woke up with the above-mentioned symptoms and decided to use the app since he is deeply concerned about this unknown condition.

Examination results: No observed circumferential increase, pressure pain over the thigh muscles ventrally, not dorsally; pressure pain over the gluteal muscles; no discomfort in the lower leg or anywhere else in the body; only axial loading is possible. Active ROM in the hip and knee joint is limited due to the pain in the thigh; passive movement is possible with light stretching exercises. Peripheral circulation, motor function and sensitivity is intact, no wounds, no hematoma visible.

Not anticipated while creating the vignette (and filled in while using the app in this trial): Feeling of heavy legs, no lumps under the skin of the thighs

Answers suspected not to be answered by the fictional patient: N/A

Number of symptom-related questions: 22

General app estimation (“next steps”): People with symptoms similar to yours can usually manage their symptoms safely at home. You could also seek advice by visiting or contacting your local pharmacy. If your symptoms persist longer than expected, if they get worse, or if you notice new symptoms, you should consult a doctor for further assessment and advice.

Suggested diagnoses: 1. Delayed-onset muscle soreness of the lower extremity (can usually be managed at home): 5 out of 10 people with these symptoms had this condition 2. Quadriceps strain (can usually be managed at home): 2 out of 10 people with these symptoms had this condition

Note: N/A