1/41. Concussion in sports and recreation.More than 800 sports-related concussions occur in the united states each day, sometimes involving high-profile athletes whose injuries reach public awareness through sports broadcasts and news media. Although nonphysicians are often present and relied upon for the detection of concussion in the sports setting, the proper diagnosis and management of this neurological problem require a physician's thoughtful attention to the athlete's signs and symptoms. This article offers a diagnostic protocol and treatment recommendations as well as a useful grading scale and management strategy for return to competition.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/41. Cervical spine injuries in the athlete.Special considerations must be brought into play when the physician is consulted about when to allow an athlete to return to play following injury. This is especially true for brain and spinal cord injury. Although it is generally best to be on the conservative side, being too reticent about allowing any athlete to return may be very detrimental to the athlete and/or the entire team. Therefore, it behooves the sports physician to be circumspect with regard to not only the type of injury the athlete has suffered but also the nature, duration, and the repetitive aspects of the trauma along with the inherent strengths of any player. This article will provide the sports physician with criteria for making sound decisions regarding return to competition after cervical spine injury and "functional" cervical spinal stenosis.- - - - - - - - - - ranking = 1.5keywords = physician (Clic here for more details about this article) |
3/41. Injury severity and neuropsychological and balance outcomes of four college athletes.Recent evidence suggests significant short-term neurocognitive deficits following mild traumatic brain injury (MTBI) in sports. However, sequelae of mild head injuries is complicated by many factors including a history of multiple head injuries and injury severity. Few studies have considered the influence these variables may have on proper classification of a MTBI and their meaning for return-to-play guidelines. This study presents the short-term neuropsychological and balance outcomes of four college athletes who sustained mild head injuries of different severity (grade I, grade II, grade III and multiple head injured with a grade II based on American Academy of neurology guidelines). The results demonstrated that self-report symptoms of concussion were slow to resolve in the grade III and multiple concussed individuals. For neuropsychological testing, Trails A & B, Symbol Digit Modalities Test and Digits Span Backwards were the most sensitive in identifying differences between the injuries. For balance assessments using the Neurocom Smart Balance System, the Sensory Organization Test and reaction time were also important variables in detecting differences among the various injuries. When these data are used together, it can assist physicians in determining safe return-to-play for athletes who sustain MTBI. There are contradindications in the numerous grading systems and return-to-play guidelines for MTBI. The results from this study provides new evidence which can be assimilated into a valid grading scale for MTBI sustained in sport.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
4/41. sports-specific concerns in the young athlete: basketball.basketball is played by millions of athletes throughout the world and is the most popular team sport in American high schools. basketball is the leading cause of sports-related injury in the united states. Acute basketball injuries most often involve the extremities, especially the hands, wrists, ankles, and knees. This article reviews the history, epidemiology, and common injury patterns that occur in this sport. We include several case reports to emphasize diagnostic dilemmas frequently encountered by emergency physicians.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
5/41. MR Imaging of sports-related pseudotumor in children: mid femoral diaphyseal periostitis at insertion site of adductor musculature.OBJECTIVE: The objective of this study was to review the imaging appearance of the femurs of five patients who had been referred from outside institutions after presenting with thigh pain and being given a preliminary diagnosis of primary malignant bone tumor. Typically, when making a diagnosis, physicians place emphasis on the characteristic appearances of diseases on MR imaging, but such appearances may be misleading. An awareness of the specific MR imaging pattern of stress-related partial muscle avulsion can lead to the correct diagnosis. CONCLUSION: Femoral diaphyseal periostitis after a sports injury to the adductor musculature in children has a characteristic imaging appearance. This condition can initially appear to be misleadingly aggressive. knowledge of the findings-particularly of the findings on MR imaging-in the proper clinical setting can help physicians make the correct diagnosis and eliminate unnecessary biopsy or inappropriate treatment.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/41. Tarsal navicular stress fracture in a young athlete: case report with clinical, radiologic, and pathophysiologic correlations.BACKGROUND: Tarsal navicular fractures are uncommon but important causes of foot pain. Being alert to this condition can help prevent a delay in the diagnosis. methods: A literature search of medline was undertaken, and a case report of an adolescent with tarsal navicular stress fracture is described. RESULTS AND CONCLUSIONS: Tarsal navicular fractures are often misdiagnosed for months. Because plain radiographs are unreliable, the diagnosis of tarsal navicular fractures requires the use of bone scan, fine-cut computed tomographic scans, or magnetic resonance imaging. Treatment requires strict non-weight-bearing activities to avoid complications. When the alert primary care physician can diagnose this condition, treatment of tarsal navicular fractures can be effective and rewarding.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
7/41. Two years of debilitating pain in a football spearing victim: slipping rib syndrome.INTRODUCTION: Blunt chest trauma can occur in a variety of sports, and lead to rib fractures and less commonly known and diagnosed injuries. We report the case of a 14-yr-old student athlete who was speared (helmet tackled) in a practice scrimmage sustaining a painful injury that eluded diagnosis and treatment for more than 2 yr. methods: The case history of pain treatments and radiological evaluations is presented. RESULTS: Ultimately, a definitive diagnosis of "slipping rib syndrome" was achieved through a simple clinical manipulation (the hooking maneuver), combined with a history of symptomatic relief provided with costochondral blockade. Surgical resection of the slipping rib provided total resolution of the problem. CONCLUSION: Very few clinicians are aware either of the syndrome or the maneuver used to diagnose this condition. Although spearing has been outlawed in American football for years, it remains a commonplace occurrence, and sports physicians should be aware of the potential consequences to the victim as well as those to the perpetrator.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
8/41. Treatment of bipolar, seizure, and sleep disorders and migraine headaches utilizing a chiropractic technique.OBJECTIVE: To discuss the use of an upper cervical technique in the case of a 23-year-old male patient with rapid-cycling bipolar disorder, sleep disorder, seizure disorder, neck and back pain, and migraine headaches. CLINICAL FEATURES: The patient participated in a high school track meet at age 17, landing on his head from a height of 10 ft while attempting a pole vault. Prior to the accident, no health problems were reported. Following the accident, the patient developed numerous neurological disorders. Symptoms persisted over the next 6 years, during which time the patient sought treatment from many physicians and other health care practitioners. INTERVENTION AND OUTCOME: At initial examination, evidence of a subluxation stemming from the upper cervical spine was found through thermography and radiography. chiropractic care using an upper cervical technique was administered to correct and stabilize the patient's upper neck injury. Assessments at baseline, 2 months, and 4 months were conducted by the patient's neurologist. After 1 month of care, the patient reported an absence of seizures and manic episodes and improved sleep patterns. After 4 months of care, seizures and manic episodes remained absent and migraine headaches were reduced from 3 per week to 2 per month. After 7 months of care, the patient reported the complete absence of symptoms. Eighteen months later, the patient remains asymptomatic. CONCLUSION: The onset of the symptoms following the patient's accident, the immediate reduction in symptoms correlating with the initiation of care, and the complete absence of all symptoms within 7 months of care suggest a link between the patient's headfirst fall, the upper cervical subluxation, and his neurological conditions. Further investigation into upper cervical trauma as a contributing factor to bipolar disorder, sleep disorder, seizure disorder, and migraine headaches should be pursued.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
9/41. Traumatic superficial temporal artery pseudoaneurysms in a minor league baseball player: a case report and review of the literature.Traumatic STA aneurysm is a rare complication of facial trauma occuring typically in young men. We present the case of a minor league baseball player who developed 2 pseudoaneurysms after being struck by a baseball and review all cases associated with sports activities. Reports associated with sports activities are increasing and may represent an increasing incidence. The team physician should suspect this condition when a player presents with a new temporal mass after facial trauma. diagnosis is typically made on history and physical examination, but can be confirmed by duplex ultrasound. Definitive treatment is surgical resection of the aneurysm after proximal and distal ligation of the vessel.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
10/41. obesity in a high school football player.When a physician disqualifies an athlete based on theoretical deleterious effects, he is doing so based on the perception that the risk of participation is sufficient to override the athlete's desire to participate (4). If sports participation is very important to the athlete, the sports physician should determine what interventions might reduce the risk of participation. Rather than look for reasons for disqualification, the team physician should look for ways for the athlete to participate more safely and reduce the risk of injury. (If the risk of participation is too high, the athlete should be disqualified.) In this case an aggressive shoulder rehabilitation program and prompt follow-up of his asthma and anemia would have been helpful to this athlete's participation in football. In general, team physicians should weigh all the potential risks and benefits in each case and involve the athlete and the family when these difficult playability issues arise. The team physician should be mindful of potential conflicts of interests and should be careful to avoid imposing his or her own values on the athlete. In this case, the disqualification of this athlete based on obesity was not in his best interest. Whether the potential conflicts in decision making played a role in the decision in this case will never be known. Weighing the facts as presented, I believe the athlete's interests would have been better served by allowing him to play after completing a shoulder rehabilitation program.- - - - - - - - - - ranking = 2.5keywords = physician (Clic here for more details about this article) |
| | Next -> |