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1.  CHRONIC LEG PAIN IN A DIVISION II FIELD HOCKEY PLAYER: A CASE REPORT 
Exertional compartment syndromes in athletes represent a diagnostic and management challenge for clinicians. The clinical presentation of exertional compartment syndrome is similar to other more common musculoskeletal disorders. A lack of special tests or unique diagnostic identifiers for use in decision making by out‐patient clinicians complicates early recognition of this disorder and may delay optimal management. The purpose of this case report is to retrospectively explore the clinical presentation and the decision‐making during the course of care of a field hockey athlete eventually determined to have exertional compartment syndrome. Suggestions to assist in recognition and guidance in patient management are included as well as the procedures required for differential diagnosis. Procedures utilized during conservative care are also described in detail.
Level of Evidence:
5 (Single Case Report)
PMCID: PMC3924616  PMID: 24567863
Compartment syndrome; diagnosis of leg pain; fasciotomy
2.  DIAGNOSTIC IMAGING OF THE THROWING ATHLETE’S SHOULDER 
The diagnostic capabilities of advanced imaging have increasingly enabled clinicians to delineate between structural alterations and injuries more efficiently than ever before. These impressive gains have unfortunately begun to provide a reliance on imaging at the loss of quality in the clinical examination. Ideally, imaging of the shoulder complex is performed to confirm the provisional diagnosis developed from the history and clinical exam rather than to create such. This clinical commentary will provide the framework for both basic and advanced uses of imaging as well as discussion of evolving modalities.
Level of Evidence:
5
PMCID: PMC3811741  PMID: 24175143
Throwing athlete; shoulder pain; imaging; diagnosis
3.  A simulated passive intervertebral motion task: observations of performance in a cross-sectional study 
Introduction:
Passive motion palpation is an integral component in examination, diagnosis or classification, and treatment of persons with mechanical disorders of the cervical spine. If the magnitude of force application during passive movement assessment is associated with greater palpatory accuracy has not been established.
Methods:
This investigation used a novel mechanical model as a basis for assessing the palpatory force of students and clinicians. The model included multiple palpable resistance and displacement levels similar to that observed in humans. The ability of the subjects to discriminate the various levels of resistance and displacement offered by the model was concurrently measured.
Results:
Large variability occurred in the amount of force applied by the subjects in completing the palpatory examination. The data indicated no major differences in palpatory accuracy across the student and clinician groups with different training and experience levels beyond basic competency. Those subjects applying less force in the palpatory exam demonstrated greater accuracy of palpatory assessment with one measure.
Discussion:
The data indicate training and experience had minimal relationship to palpatory interpretation precision beyond the basic level and individual natural discriminatory ability may be a factor in accuracy of palpatory skill. The results demonstrate remarkable inconsistency in palpatory force among examiners and suggest that palpatory accuracy may be related to less force application.
doi:10.1179/2042618612Y.0000000004
PMCID: PMC3419568  PMID: 23904750
Passive intervertebral motion; Palpatory examination; Cervical spine mechanical model; Joint play; Cervical spine examination
4.  ANTERIOR CRUCIATE LIGAMENT INJURY DIAGNOSIS AND MANAGEMENT IN A PEDIATRIC PATIENT: A CASE REPORT 
The management of the skeletally immature athlete sustaining injury to the anterior cruciate ligament and other knee structures provides multiple challenges for both the treating clinicians and parents of the injured child. The diagnostic process and subsequent decision making present additional complexities because of the developmental anatomy and the potential for disturbance of normal growth patterns by some surgical interventions. In the following case report, the course to appropriate management of a young athlete is detailed, including the contributions of imaging results. The reconstructive options available to orthopedic surgeons and the patient's post‐operative progression are also briefly discussed. Rehabilitation practitioners require an understanding of the unique issues present when providing care for pediatric and adolescent athletes with knee injuries in order to assist in optimal decision making in the phases during which they are involved.
Level of Evidence:
5 (Single Case Report)
PMCID: PMC3537458  PMID: 23316431
Anterior cruciate ligament; adolescent; open physis; pediatric; skeletal immaturity
5.  PERSISTENT WRIST PAIN IN A MATURE GOLFER 
Clients presenting with ulnar-sided wrist pain can provide diagnostic and management challenges for physical therapists. Symptoms in this region may originate from multiple structures. Integration of clinical examination and diagnostic imaging results is often required for optimal decision-making and patient management. To obtain the most informative imaging results, practitioners need an understanding of injury patterns and their detection by various imaging modalities. This case describes a mature golfer who presented with persistent ulnar-sided wrist pain and was eventually determined to have a fracture of the hook of the hamate accompanied by neighboring soft tissue involvement also contributing to his symptom complex. His history and the diagnostic process are detailed along with a brief discussion of his subsequent management post-operatively.
Level of Evidence:
5 (Single Case Report)
PMCID: PMC3414074  PMID: 22893862
wrist pain; hamate fracture; golf injury

Results 1-5 (5)