Clinics in sports medicine
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Collegiate athletes are common reservoirs for infectious disease agents. Specific training regimens, living arrangements, and high-risk behaviors may influence the athlete's risk of contracting a variety of infectious diseases. The sports medicine physician plays an important role in recognizing, appropriately treating, designing prevention strategies for, and making return-to-activity decisions for athletes who have infectious diseases.
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The role of a team physician is an integral part of establishing a new practice. Regardless of the type of practice one enters, the team physician role provides an opportunity to establish an early referral base to build the foundation of a successful practice. Although this comes with great responsibility and significant time commitments, the joy of developing your practice doing what you enjoy most, sports medicine, makes these drawbacks less perceptible. Using all your potential resources and keeping your eye on the ball will simplify reaching the goal of having a happy, healthy, and rewarding career.
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Sports-related injuries to the wrist range from minor sprains to severe soft tissue disruption that can pose a risk to the normal function of the upper extremity. It is important to identify the specific nature of such injuries so as to establish an accurate diagnosis and deliver appropriate treatment. MRI of the wrist has greatly benefited from the use of dedicated surface coils, which allow fine depiction of soft tissue and cartilaginous structures. A review of the normal anatomy, MR interpretation pitfalls, and most common abnormalities of the tendons, ligaments, triangular fibrocartilage complex, and nerves of the wrist are presented.
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MRI is a useful diagnostic method for evaluating nerve disease at the shoulder and elbow. MRI can depict the normal anatomy of the nerves, confirm and identify the cause of the neuropathy, identify the site of entrapment based on muscle denervation patterns, and detect unsuspected space-occupying lesions. MRI can also narrow down the differential diagnosis of nerve disease, such as in the case of suprascapular nerve syndrome versus Parsonage-Turner syndrome, or radial tunnel syndrome versus lateral epicondylitis. Large prospective studies with surgical correlation, however, are still necessary to better elucidate MRI's exact role in the assessment of entrapment neuropathies of the upper extremity.
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The two major imaging modalities used for assessment of soft tissue injuries are ultrasound and MRI. Although ultrasound of the extremities is used only to a limited extent in the United States, it is widely used in many other countries for evaluation of extremity injuries. ⋯ The uses of ultrasound for evaluating sports medicine injuries in specific regions of the upper extremity are then reviewed. Where the data are available, the reported accuracy of ultrasound is compared with MRI for each type of injury.