Physician Sportsmed
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Undetected scaphoid fractures may lead to complications, including nonunion, malunion, avascular necrosis, and wrist arthritis. A competent physical examination is essential for the diagnosis of scaphoid fractures in the setting of occult fractures presenting with normal radiographs. ⋯ The 2 key points of such an examination include the exact location of point tenderness and provocative special tests. Although Watson's scaphoid shift test is classically described for scaphoid instability, we highlight its significance in the setting of scaphoid fractures.
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Physician Sportsmed · Apr 2009
Case ReportsCase report: injuries associated with interactive game consoles: preliminary data.
The use of motion-sensing video game software has provided users with the ability to mimic movements in many sports such as baseball, tennis, and boxing. Epidemiology on injuries and overuse of motion-sensing video game systems is minimal because the systems have only been available for 2 years. This case series report presents preliminary data on injuries related to the game systems from the first full year of use. ⋯ Results indicated that females were more prone to injuries, and the mean age was 16 years. Most injuries were soft tissue in nature and located in the shoulders, hands and fingers, and the face and neck region. Our discussion includes prevention strategies for reducing injury risk when playing motion-sensing video games.
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Clay shoveler's fracture is a repetitive stress injury that affects the spinous process of the lower cervical and upper thoracic spine. In sports, deceleration forces caused by the pull of the trapezius, rhomboids, and the ligamentum nuchae on the neck probably exert repetitive traction on their attachment sites to the narrow spinous processes. The condition is known in manual laborers, but it is rare in athletes, as in this case of a volleyball player. Early recognition and treatment with rest, analgesics, and physical therapy are important to prevent debilitating chronic back pain.
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Physician Sportsmed · May 2004
Complex regional pain syndrome: redefining reflex sympathetic dystrophy and causalgia.
Complex regional pain syndrome (CRPS) is the new nomenclature that encompasses the older diagnostic entities of reflex sympathetic dystrophy (now CRPS 1) and causalgia (CRPS 2). CRPS arises after injuries such as sprains, strains, or fractures, but in some patients the cause is unknown. Although a perennial suspect in the pathogenesis of this entity, the sympathetic nervous system's role in CRPS remains unclear. New studies provide insight into the contribution of the sympathetic nervous system to CRPS and allow reevaluation of clinical features, diagnostic criteria, testing methods, and treatment modalities.
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I had one of the most rewarding nights of my medical career tonight. I delivered the baby of a woman whom I treated for an eating disorder 7 years ago. I remember the day her parents first brought her to see me, the sports medicine specialist. ⋯ The patient told me she'd eaten nothing for 3 days before her visit, and that I couldn't make her eat. It's intimidating even when a 15-year-old is yelling at you at the top of her lungs. Yet I stood my ground, related the treatment plan, had my nurse draw her blood, and told the girl to come back in a week.