Sport Medicine

Question 1

Adolescent plays football, presents with pain in the right knee, swollen tender tibial tubercle; plain radiograph shows ossification of the tibial tubercle with fragmentation

Answer 1

Osgood–Schlatter disease

Question 2

What is the best treatment of Osgood–Schlatter disease?

Answer 2

Icing, muscle stretching, and strengthening decrease activities triggering the pain, NSAIDs, knee brace

Question 3

An 8-year-old boy recently starts playing basketball for 2h every day, he is complaining of pain in both heels, the pain is worse when jumping and with exercise. The exam is positive for tenderness at both heels and and with dorsiflexion of both feet

Answer 3

Sever disease

Question 4

What is the best treatment of Sever disease?

Answer 4

Icing, stretching of Achilles tendon, NSAIDs, heel cups, avoid activities triggering the pain, e.g., jumping

Question 5

Adolescent girl is complaining of right hip pain that developed during track practice. She felt a pop in the front of her right hip and had immediate onset of pain. There is tenderness over anterior inferior iliac spine, pain and weakness with resisted hip flexion, and pain with passive extension of the hip. What is the most likely diagnosis?

Answer 5

Anterior inferior iliac spine (AIIS) apophyseal avulsion injury (due to strong muscle contraction and skeletal immaturity and relatively weak apophysis)

Question 6

Healthcare providers should educate athletes at high risk for ACL tear about neuromuscular training programs that reduce the risk of injury. What are the components of neuromuscular training?

Answer 6

Strengthening, balance, and plyometric (jump) training, proper knee position and technique

Question 7

What are the highest rates of dental injuries among high school sports in boys?

Answer 7

Basketball, baseball, wrestling, and soccer

Question 8

What are the highest rates of dental injuries among high school sports in girls?

Answer 8

Field hockey, softball, basketball, and lacrosse

Question 9

What is the best protective gear during sports that decreases oral injuries, including tooth avulsions, tooth fractures, and lacerations?

Answer 9

Mouthguard

Question 10

Adolescent with a history of 3 concussions is suffering from forgetfulness and difficulty concentrating since last concussion, which was 2months ago. What is the best diagnostic test to identify impaired cognitive function?

Answer 10

Neuropsychological testing

Question 11

Adolescent with a history of scoliosis is in your office for sports clearance. Physical examination is significant for pectus excavatum, hypermobility of the wrist and finger joints, long and thin fingers, arm span–to–height ratio that is greater than 1.05 What is the next best step?

Answer 11

Echocardiography (Marfan syndrome is a high risk of aortic root rupture and aortic dissection)

Question 12

What is the best treatment of apophyseal avulsion injuries?

Answer 12

Rest and protected weight- bearing; surgery is rarely indicated

Question 13

Adolescent boy presents to your office for preparticipation evaluation before football season. He has a history of 2 episodes of syncope. What is the most important finding that warrants a through cardiology evaluation?

Answer 13

Syncope during exercise

Question 14

What is the best drink for sports activities lasting 1h or less?

Answer 14

Water is enough for hydration

Question 15

What is the best drink for sports activities lasting longer than 1h?

Answer 15

Sports drinks (contain electrolyte and sugar; may encourage for hydration with longer activities)

Question 16

A father is asking about energy drinks for his children during sports

Answer 16

Not recommended for young children and adolescents (due to high caffeine level in energy drinks)

Question 17

An athlete has been doing strenuous exercise for a prolonged period in hot weather, excessively sweating, dizziness, thirst, weakness, headache, malaise, tachycardia, and the temperature is 103°F

Answer 17

Heat exhaustion

Question 18

An athlete has been doing strenuous exercise for a prolonged period in hot weather, presents with dry and hot skin, feeling dizzy, weak, altered mental status, low blood pressure, and tachycardia, and the temperature is 105°F

Answer 18

Heat stroke

Question 19

What is the next best step in an athlete with suspected heat stroke?

Answer 19

Rapid and immediate cooling (ice water bath) at the scene then transfer to the ED

Question 20

An athlete is complaining of headaches, dizziness, poor concentration after a head concussion while playing volleyball. What is the next best step?

Answer 20

Remove from sports. Neurocognitive rest

Question 21

Adolescent boy is presenting with a large swelling in the left thigh after hitting another player during the game, radiograph on the left femur is normal. What is the most likely diagnosis?

Answer 21

Soft-tissue hematoma

Question 22

A 17-year-old boy is interested in building muscles, the mother is concerned about his acne, aggressive behavior. Gonads are small for age. What is the most likely underlying cause?

Answer 22

Anabolic steroids intake