EM sports medicine Flashcards
_____ is an overuse syndrome resulting in inflammation of the proximal tibial apophysis at the point of insertion of the patellar tendon. It is similar to patellar tendonitis in adults except the point of inflammation is the epiphysis of the tibial tuberosity.
Osgood-Schlatter disease. It is postulated that the sudden growth of adolescence combined with repeated extension/flexion of the quadriceps muscle contributes to the specific pathology of this preadolescent/adolescent disorder.
______ comprises the bulk of sports-related deaths not attributed to an underlying cardiovascular disease and occurs when blunt, nonpenetrating trauma to the chest produces ventricular fibrillation during the vulnerable period of cardiac repolarization.
Commotio cordis. Survival is generally less than 15% but improves if prompt cardiovascular resuscitation and defibrillation occur. Commotio cordis is most common in children and adolescents with mean age of 13 years.
______ is an idiopathic osteonecrosis or avascular necrosis of the capital femoral epiphysis. Usual age of onset is between 2 to 12 years; there is a male to female ratio of 4:1. The presentation is that of mild or intermittent pain in the anterior thigh and a limp. Physical examination shows antalgic gait, proximal thigh atrophy, and mild shortness of stature.
Legg-Calve-Perthes disease
____ refers to a benign inflammation of the hip joint that affects children ages 3 to 8 years. 70% of patients have a preceding upper respiratory infection 1 to 2 weeks prior to the onset of symptoms. The patient usually complains of a limp, with pain in the hip or pain that is referred to the knee.
Transient synovitis
_____ is a lesion, usually of the tibia, that affects children ages 1 through 10 years. Symptoms are anterior swelling or enlargement of the leg without pain. Radiographs would differentiate Osgood-Schlatter disease from osteofibrous dysplasia, with the latter showing solitary or multiple lucent, cortical diaphyseal lesions surrounded by sclerosis.
Osteofibrous dysplasia
_____ is an avascular necrosis of the bone underlying the articular cartilage. Some lesions are asymptomatic and found incidentally, whereas others are manifested as edema, pain, and limited mobility. The bones involved are usually the medial femoral condyle and the talus.
Osteochondritis dissecans
Fracture of the __________ is the most likely injury in the skeletally immature athlete who has inverted the ankle, has open growth plates and experiences pain on palpation of the lateral ankle.
fibular physis or growth plate
The large _______, is the most frequently injured, accounting for 60% to 70% of all carpal fractures. Hyperextension of the wrist while falling on an outstretched hand is the most common mechanism of injury.
scaphoid bone, or carpal navicular. It can be a frequently missed injury; approximately 10%-15% of fractures are not seen on initial routine radiographs, but after 10-14 days, bony reabsorption occurs at the fracture site.
The history and clinical exam findings are suggestive of a possible type I tibial tubercle fracture versus Osgood-Schlatter disease (OSD), which is more chronic and associated with less severe symptoms due to forces exerted on the tibial tubercle by the patellar tendon in rapidly growing adolescents during sports involving jumping and squatting.
A _____ would be most helpful in detecting bony edema consistent with an occult tibial tubercle fracture.
magnetic resonance imaging (MRI)
Young athletes who spend a lot of time on their knees, such as baseball catchers, develop an irritated and inflamed bursa that can fill with blood, resulting in significant swelling, tenderness, redness, and pain with knee flexion.
This swelling is usually superficial to the patella. Imaging studies are not generally helpful for diagnosis. If swelling were located at the medial or lateral knee joint, effusion within the knee joint itself would be more likely.
This may cause a partial avulsion fracture through the ossification center where secondary heterotopic bone formation may occur.
Patients usually experience tenderness and swelling over the tibal tubercle. It is a self-limiting condition requiring rest, ice, and anti-inflammatory medication until the growth plates have closed.
A 14-year-old cross country runner has a 3 to 4-week history of vague anterior knee pain, which is most noticed while climbing up stairs and after sitting with her legs folded under her. She occasionally notices a crinkling sound and sensation when climbing stairs. On exam there is no effusion or erythema, and range of motion of her knees are normal. She complains of slight tenderness over both inferior patellar poles.
The history and physical findings in this patient are most consistent with patellofemoral syndrome (PFS), a common cause of vague anterior knee pain especially in adolescent runners and females.
Pain relief with knee bracing, anti-inflammatories, and patellar taping are helpful and should be followed by extensive physical therapy consisting of iliotibial band stretching and medial quadriceps strengthening exercises.
______ is used for the evaluation of specific muscle groups in which a voluntary isometric (muscle length remains constant) contraction is used.
Isometric strength testing
During a pre-participation screening, what is an essential component of screening for all students regardless of their past medical history?
To screen for any cardiovascular problems that could affect the child (history of heart murmurs, known structural heart disease) or in any of the family members (genetic disorders with cardiac involvement), it is necessary to obtain a detailed cardiovascular history as part of pre-participation screening of students.
Besides a routine physical examination, what sort of examination finding would be helpful in determining whether or not he can safely engage in weight training?
Tanner Stage 5 represents adult sized genitalia, which is characterized by a testicular volume of greater than 20ml. Body mass index, height, body fat content, and/or eruption of wisdom teeth do not predict adequate skeletal and sexual maturity; therefore, they cannot be relied upon to determine the readiness for weight training and power lifting.
