1/4. Sudden death from contusion of the right atrium after blunt chest trauma: case report and review of the literature.Occult cardiac injury following blunt trauma is more common than generally suspected. Myocardial lesions range from myocardial contusion to cardiac rupture. Myocardial contusion is not uncommon, it is usually a benign disorder which often remains undiagnosed. We report the case of a previously healthy 29-year-old man who was involved in a fight and suffered from blunt heart injury leading to contusion of the right atrium. The patient died soon after the injury and before admission to the Hospital. The diagnosis was made at autopsy. The present case is of special interest because of the unusual eliciting event and the rarity of the contusion site (right atrium). It is reported in order to raise the index of suspicion in physicians treating patients involved in a fight and aid in prompt diagnosis of myocardial contusion.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/4. Nonligamentous problems of the athlete's knee.Acute and chronic nonligamentous problems of the athlete's knee are outlined, emphasizing diagnosis and treatment. Most such problems can be managed by the family physician or general practitioner, and recommendations are made for the referral of more complex problems.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/4. Training room evaluation of chest pain in the adolescent athlete.A physician or athletic trainer will often be faced with an athlete complaining of chest pain during or after an event. chest pain in children and adolescents is usually of a noncardiac origin; only 5% of cases are due to cardiac problems. With a properly documented history and physical evaluation, one can usually identify the etiology of the chest discomfort or at least rule out any serious difficulties. The various diagnostic possibilities include cardiac, musculoskeletal, pulmonary, gastrointestinal, and psychiatric causes of pain. We discuss several specific conditions, as well as the signs, symptoms, and basic management.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/4. Two cases of psychogenic purpura.Psychogenic purpura, also known as recurrent painful bruising or autoerythrocyte sensitization syndrome (Gardner-diamond syndrome) is usually associated with emotionally disturbed patients. It is a troublesome entity for both patient and physician since extensive work-ups yield no diagnosis. We describe two females in their early twenties with recurrent painful bruising and diverse accompanying symptoms which appeared after physical trauma. One of the patients developed a bruise after intradermal injection of her own blood (with no reaction to saline injection). One patient had a personality (borderline) disorder, the other a factitious disorder. Punch biopsies revealed a perivascular inflammatory infiltrate, erythrocyte extravasation and no vasculitis. Psychogenic hemorrhagic disorders are uncommon yet must be considered in the differential diagnosis of purpura. patients are usually young emotionally troubled females who present painful recurrent bruises on extremities frequently after trauma or surgery. Autoimmune mechanisms and increased cutaneous fibrinolytic activity have been implicated, although further studies are needed. Correct diagnosis is important to avoid aggressive and even mutilating treatments, and an adequate comprehension of these purpuras is important for the attending physician.- - - - - - - - - - ranking = 2keywords = physician (Clic here for more details about this article) |