Sports Medicine

322 Pages·2011·1.77 MB·English

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SPORTS MEDICINE
Examination & Board Review
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EDITORS
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Francis G. O’Connor, MD, FACSM
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Director, Sports Medicine Fellowship Progrcam
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Associate Professor of Family Medipcine
Department of Family Medicine
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Uniformed Services University of the Health Sciences
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Bethesda, Maryland
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Robert E. Sallis, MD, FAAFP, FACSM
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Co-Director, Spoorts Medicine Fellowship
Kaiser Pehrmanente Medical Center
Fontana, California
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Roberwt P. Wilder, MD, FACSM
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Associate Professor Physical Medicine and Rehabilitation
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Medical Director the Runner’s Clinic at UVA
Team Physician, UVA Athletics, The University of Virginia
Charlottesville, Virginia
Patrick St. Pierre, MD
Assistant Professor of Orthopedic Surgery
Uniformed Series University of the Health Sciences
Bethesda, Maryland
Associate Director Nirschl Orthopedic
Sports Medicine Fellowship
Arlington, Virginia
SPORTS MEDICINE
Examination & Board Review
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Francis G. O’Connor
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Robert E. Salluis
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Robert P. Wilder
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Patrick St. Pierre
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DOI: 10.1036/0071446303
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Contents
Contributors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxv
QUESTIONS
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SECTION 1. GENERALCONSIDERATIONS. . . . . . . . . . . . . . . .c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
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1. The Team Physician . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
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Anthony I. Beutler, Christopher B. Ranney, and John H. Wilckens
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2. Ethical Considerations in Sports Medicrine. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
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Ralph G. Oriscello
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3. Legal Issues . . . . . . . . . . . . . . . . . m. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Aaron Rubin
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4. Field Side Emergencies. . . h. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Michael C. Gaertnerand Loretn A. Crown
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5. Mass Participation wEvents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Scott W. Pyne
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6. Catastrophicw Sports Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Barry P. Boden
7. Terminology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Scott A. Magnes
8. Basics in Exercise Physiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Patricia A. Deusterand David O. Keyser
9. Articular Cartilage Injury. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Stephen J. Beeand Brian J. Cole
10. Muscle and Tendon Injury and Repair. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Bradley J. Nelsonand Dean C. Taylor
11. Bone Injury and Fracture Healing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Carlos A. Guanche
12. The Preparticipation Physical Examination. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Robert E. Sallis
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13. Basic Principles of Exercise Training and Conditioning . . . . . . . . . . . . . . . . . . . . . . . . 17
Craig K. Seto
14. Nutrition. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Nancy M. DiMarcoand Eve V. Essery
15. Exercise Prescription. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Mark B. Stephens
16. Exercise and Chronic Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Karl B. Fields, Michael Shea, Rebecca Spaulding, and David Stewart
17. Playing Surface and Protective Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Jeffrey G. Jenkinsand Scott Chirichetti
SECTION 2. EVALUATION OF THE INJURED ATHLETE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
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18. Diagnostic Imaging. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
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Leanne L. Seeger and Kambiz Motamedi
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19. Electrodiagnostic Testing . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
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Venu Akuthota and John Tobey
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20. Exercise Stress Testing . . . . . . . . . . . . . . . . . .o . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
David E. Price, Kevin J. Elder, and Russell D. Whirte
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21. Gait Analysis . . . . . . . . . . . . . . . . . . . . e. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
D. Casey Kerrigan and Ugo Della Croce m
22. Compartment Syndrome Testinog. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
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John E. Glorioso and John H. Wilckens
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23. Exercise-Induced Asthma Testing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
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24. Drug Testing. . . . w. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
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SECTION 3. MEDICALPROBLEMS IN THE ATHLETE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
25. Cardiovascular Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Francis G. O’Connor, John P. Kugler, and Ralph P. Oriscello
26. Dermatology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Kenneth B. Batts
27. Genitourinary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
William S. Sykora
28. Ophthalmology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Ronica A. Martinez and Kayvan A. Ellini
29. Otolaryngology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Charles W. Webb
30. Dental . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Elizabeth M. O’Connor
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31. Infectious Disease and the Athlete. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
John P. Metz
32. Endocrine Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
William W. Dexter and Kevin J. Broderick
33. Hematology in the Athlete. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
William B. Adams
34. Neurology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Jay Erickson
35. Gastroenterology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
David L. Brown and Chris G. Pappas
36. Pulmonary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Carrie A. Jaworski
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37. Allergic Diseases in Athletes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
David L. Brown, David D. Haight, and Linda L. Brown o
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38. Overtraining Syndrome/Chronic Fatigue. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
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39. Environmental Injuries. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
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Brian V. Reamy
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SECTION 4. MUSCULOSKELETALPROBLEMm S IN THE ATHLETE. . . . . . . . . . . . . . . . . . . . . . . . 55
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40. Head Injuries. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
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Robert C. Cantu
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41. Cervical Spine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
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Gerard A. Malanga, Garrett S. Hyman, and Jay E. Bowen
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42. Thoracic and Lumbar Spine. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
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Scott F. Nadler and C. Michele Miller
43. Magnetic Resonance Imaging: Technical Considerations and Upper Extremity . . . . 58
Carolyn M. Sofka
44. Shoulder Instability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
Augustus D. Mazzocca and Robert A. Arciero
45. Rotator Cuff Pathology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Patrick St. Pierre
46. Sternoclavicular, Clavicle, and Acromioclavicular Injuries. . . . . . . . . . . . . . . . . . . . . . 62
Carl J. Basamania
47. Shoulder Superior Labrum, Biceps, and Pec Tears. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
Jeffrey S. Abrams
48. The Throwing Shoulder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
Carlos A. Guanche
49. Elbow Instability. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Derek H. Ochiai and Robert P. Nirschl
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50. Elbow Articular Lesions and Fractures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
Edward S. Ashman
51. Elbow Tendinosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Robert P. Nirschl and Derek H. Ochiai
52. Soft Tissue Injuries of the Wrist in Athletes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
Steven B. Cohen and Michael E. Pannunzio
53. Soft Tissue Injuries of the Hand. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72
Todd C. Battaglia and David R. Diduch
54. Wrist and Hand Fractures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
Geoffrey S. Baer and A. Bobby Chhabra
55. Upper Extremity Nerve Entrapment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Margarete DiBenedetto and Robert Giering
56. Magnetic Resonance Imaging: Lower Extremity. . . . . . . . . .m . . . . . . . . . . . . . . . . . . . . . 77
Carolyn M. Sofka
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57. Pelvis, Hip, and Thigh . . . . . . . . . . . . . . . . . . . . . . . . . c. . . . . . . . . . . . . . . . . . . . . . . . . . . 78
Brett D. Owens and Brian D. Busconi .
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58. Knee Meniscal Injuries. . . . . . . . . . . . . . . . . . . .u . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
John P. Goldblatt and John C. Richmond o
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59. Knee Instability. . . . . . . . . . . . . . . . . . . . g. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
Alex J. Kline and Mark D. Miller e
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60. The Patellofemoral Joint. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
Robert J. Nicoletta and Anthony A. Scohepsis
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61. Soft Tissue Knee Injuries (Tendon and Bursae) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
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John J. Klimkiewicz p
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62. Ankle Instability. . .w . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
R. Todd Hockenbury
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63. Surgical Consiwderations in the Leg. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
Gregory G. Dammann and Keith S. Albertson
64. Tibia and Ankle Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
Brian E. Abell and Edward S. Ashman
65. Foot Injuries. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88
Mark D. Porter, Joseph J. Zubak, and Winston J. Warme
66. Lower Extremity Stress Fracture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
Michael Fredericson
67. Nerve Entrapments of the Lower Extremity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
Robert P. Wilder, Jay Smith, and Diane Dahm
SECTION 5. PRINCIPLES OF REHABILITATION. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
68. Physical Modalities in Sports Medicine. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
Alan P. Alfano
69. Core Strengthening. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94
Joel Press