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1. Answer D.  Despite normal x-rays the patient had clinical signs of fracture (pain and loss of ROM).  Many times, casting a patient to provide complete immobilization of the injured site is necessary for pain control and comfort.  Most x-rays will show some evidence of a fracture after one week but sometimes can take longer.

2. Answer C.  Inversion injuries can result in distal fibula fractures, ankle sprains and midfoot sprains and/or fractures.  In this case she had an ankle sprain ...

REFERENCES:

1. PPE, Preparticipation Physical Exam, 4th Edition. American Academy of Pediatrics.

2. Essentials of Musculoskeletal Care, 4th Edition.  John F. Sarwark, Editor.

3. Tracking Neuropsychological Recovery Following Concussion in Sports. November 2004. Iverson, G. Et. al.

4. Overuse Injuries, Overtraining, and Burnout in Child and Adolescent Athletes. Brenner, Joel S.  Pediatrics 2007; 119;1242

5.  Training the Child Athlete for Prevention, Health Promotion, and Performance:  How Much Is Enough, How Much Is Too Much?  Carter and Micheli. Clin Sports Med 30 (2011) 679-690.

Lunch with the Sports Doc:  The Preparticipation Physical Exam

The  answers to the scenarios may differ from one physician to the next.  Each answer could be easily supported.  The answers posted are based on the literature and some based on clinical experience.  Feel free to differ.

Case scenario 1:  Answer is D.  Based on the literature, the risk of losing a kidney secondary to trauma is very unlikely.  Some activities that resulted in kidney loss included bicycling (competitive), skiing and horseback riding. ...

• Champion Sports Medicine presents “Lunch with the Sports Doc”
• Wednesday, May 23, 2012 from 12:15 p.m. to 1:00 p.m. at the  Quarry Golf Club
•  Topic: “Golf Injuries and Fitness”
•  Please RSVP no later than Friday, May  18, 2012 to 210-340-1710 or email us at CME@ChampionSM.net