Hip and Groin Pain in the Professional Athlete

2012 ◽  
Vol 63 (2) ◽  
pp. 87-99 ◽  
Author(s):  
Sean E. McSweeney ◽  
Ali Naraghi ◽  
David Salonen ◽  
John Theodoropoulos ◽  
Lawrence M. White

Hip and groin pain is a common condition in professional athletes and may result from an acute injury or from chronic, repetitive trauma. It is responsible for significant morbidity, which leads to time away from training and competition, and may result in a career-ending injury. The anatomic and biomechanical causes for hip and groin injuries are among the most complex and controversial in the musculoskeletal system. This makes clinical differentiation and subsequent management difficult because of the considerable overlap of symptoms and signs. This review article will evaluate several pathologic conditions of the hip and groin in athletes, divided into acute (secondary to single event) and chronic (secondary to altered biomechanical load or repetitive microtrauma) injuries, with an emphasis on imaging in the diagnosis of these injuries. Appropriate use of imaging along with clinical findings can allow accurate diagnosis and subsequent appropriate management of these patients to ultimately allow return to athletic activity.

10.2196/17349 ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. e17349
Author(s):  
Aijing Luo ◽  
Zirui Xin ◽  
Yifeng Yuan ◽  
Tingxiao Wen ◽  
Wenzhao Xie ◽  
...  

Background With the rapid development of online health communities, increasing numbers of patients and families are seeking health information on the internet. Objective This study aimed to discuss how to fully reveal the health information needs expressed by patients with hypertension in their questions in a web-based environment and how to use the internet to help patients with hypertension receive personalized health education. Methods This study randomly selected 1000 text records from the question data of patients with hypertension from 2008 to 2018 collected from Good Doctor Online and constructed a classification system through literature research and content analysis. This paper identified the background characteristics and questioning intention of each patient with hypertension based on the patient’s question and used co-occurrence network analysis and the k-means clustering method to explore the features of the health information needs of patients with hypertension. Results The classification system for the health information needs of patients with hypertension included the following nine dimensions: drugs (355 names), symptoms and signs (395 names), tests and examinations (545 names), demographic data (526 kinds), diseases (80 names), risk factors (37 names), emotions (43 kinds), lifestyles (6 kinds), and questions (49 kinds). There were several characteristics of the explored web-based health information needs of patients with hypertension. First, more than 49% of patients described features, such as drugs, symptoms and signs, tests and examinations, demographic data, and diseases. Second, patients with hypertension were most concerned about treatment (778/1000, 77.80%), followed by diagnosis (323/1000, 32.30%). Third, 65.80% (658/1000) of patients asked physicians several questions at the same time. Moreover, 28.30% (283/1000) of patients were very concerned about how to adjust the medication, and they asked other treatment-related questions at the same time, including drug side effects, whether to take the drugs, how to treat the disease, etc. Furthermore, 17.60% (176/1000) of patients consulted physicians about the causes of clinical findings, including the relationship between the clinical findings and a disease, the treatment of a disease, and medications and examinations. Fourth, by k-means clustering, the questioning intentions of patients with hypertension were classified into the following seven categories: “how to adjust medication,” “what to do,” “how to treat,” “phenomenon explanation,” “test and examination,” “disease diagnosis,” and “disease prognosis.” Conclusions In a web-based environment, the health information needs expressed by Chinese patients with hypertension to physicians are common and distinct, that is, patients with different background features ask relatively common questions to physicians. The classification system constructed in this study can provide guidance to health information service providers for the construction of web-based health resources, as well as guidance for patient education, which could help solve the problem of information asymmetry in communication between physicians and patients.


Author(s):  
James P. Dunn

Upon completion of this chapter, the reader should be able to • Describe the symptoms and signs of cytomegalovirus (CMV) retinitis in patients with AIDS. • Describe treatment options for CMV retinitis and the need for systemic therapy whenever possible. • Identify risk factors, clinical findings, and treatment of immune recovery uveitis....


2004 ◽  
Vol 33 (8) ◽  
pp. 451-457 ◽  
Author(s):  
P. Robinson ◽  
D. A. Barron ◽  
W. Parsons ◽  
A. J. Grainger ◽  
E. M. G. Schilders ◽  
...  

2011 ◽  
Vol 101 (5) ◽  
pp. 447-451 ◽  
Author(s):  
Robert M. Yoho ◽  
Shevonne K. Wells

Navicular stress injuries in athletes can be devastating. Clinical findings are frequently nonspecific until significant progression of the abnormality has occurred. The use of diagnostic imaging techniques early in the discovery period increases the likelihood of establishing an immediate diagnosis and avoids frank fracture of the navicular bone. Delayed diagnosis of navicular stress injuries in athletes can cause dire consequences. The physician must be aware of the injury in establishing a high index of clinical suspicion. The timing and sequencing of diagnostic imaging studies is essential in establishing a diagnosis to manage the patient and minimize time away from competition. This case study examines the history and management of an elite high school track athlete who sustained a navicular stress injury. The timing and use of diagnostic imaging studies is reviewed. (J Am Podiatr Med Assoc 101(5): 447–451, 2011)


Author(s):  
Ana Moragas ◽  
◽  
Ana Garcia-Sangenís ◽  
Alex Prats Escudero ◽  
Carolina Bayona Faro ◽  
...  

Objectives. We evaluated the prevalence of microbiologically-confirmed influenza infection among patients with influenza-like symptoms and compared the clinical and epidemiological characteristics of patients with and without influenza infection. Methods. Retrospective study of a cohort of patients with influenza-like symptoms from 2016 to 2018 who participated in a clinical trial in thirteen urban primary centres in Catalonia. Different epidemiological data were collected. Patients rated the different symptoms and signs on a Likert scale (absent, little problem, moderate problem and severe problem) and self-reported the measure of health status with the EuroQol visual analogue scale. A nasopharyngeal swab was taken for microbiological isolation of influenza and other microorganisms. Results. A total of 427 patients were included. Microbiologically confirmed influenza was found in 240 patients (56.2%). The percentage of patients with moderate-to-severe cough, muscle aches, tiredness and dizziness was greater among patients with microbiologically confirmed influenza. The self-reported health status was significantly lower among patients with true flu infection (mean of 36.3 ± 18.2 vs 41.7 ± 17.8 in patients without influenza; p<0.001). Conclusion. Clinical findings are not particularly useful for confirming or excluding the diagnosis of influenza when intensity is not considered. However, the presence of moderate-to-severe cough, myalgias, tiredness and dizziness along with a poor health status is more common in patients with confirmed flu infection.


Author(s):  
Farhan D Hasan ◽  
Dwiana Ocviyanti

Abstract Objective: To attain diagnostic accuracy of various gynecologic symptoms and signs in identifying causes of vaginal discharge. Method: Eighty-two subjects were included in this cross sectional study. Gynecologic symptoms and signs were inquired from each subject and further laboratory examinations were carried out to identify the etiology. Diagnostic accuracy for each symptom and sign was compared to the laboratory examination as the standard reference. Symptoms and signs with positive predictive value (PPV) of more than 50% were considered to have good diagnostic accuracy. Result: For bacterial vaginosis, excessive wetness in genital area; vulvar maceration; and thin, turbid, yellowish vaginal discharge had PPVs of 53%; 52%; and 52%, respectively. For candidal vaginitis, vulvar maceration; and white, curd-like vaginal discharge had PPVs of 58% and 100%, respectively. For trichomoniasis, thin, turbid, frothy, yellowish vaginal discharge; and strawberry-cervix appearance had PPVs of 60% and 100%, respectively. There were no symptoms or signs with PPV of more than 50% for chlamydial cervicitis. Diagnostic accuracy for clinical findings in gonorrheal cervicitis could not be calculated due to the small number of subjects. Conclusion: Various gynecologic symptoms and signs were found to be accurate in diagnosing bacterial vaginosis, candidal vaginitis, and trichomoniasis. No symptoms or signs were considered accurate to aid etiological diagnosis for chlamydial and gonorrheal cervicitis. Keywords: bacterial vaginosis, Candida sp, Chlamydia trachomatis, gynecologic symptoms and signs, Neisseria gonorrhoeae, Trichomonas vaginalis


PEDIATRICS ◽  
1959 ◽  
Vol 24 (1) ◽  
pp. 54-64
Author(s):  
J. Trenholme Griffin ◽  
Irving Kass ◽  
Murray S. Hoffman

Symptoms and signs of bronchial asthma, associated with cor pulmonale, are rare clinical findings in infants and children. Three cases are presented which suggest a relationship between the two entities. Two of the three cases did not present any evidence of atopy. Although studies of cardiopulmonary functions should be done in all children suffering from "bronchial asthma," it is essential that the cardiac status be evaluated whenever a patient with asthma is responding poorly to treatment or evidence of decreased pulmonary function is found. It is hoped that this presentation will alert physicians to cor pulmonale as a complication of asthma.


2003 ◽  
Vol 31 (4) ◽  
pp. 340-344 ◽  
Author(s):  
A Alkan ◽  
Ö Günhan ◽  
A Alkan ◽  
F Otan

We present 13 cases of oral mucous membrane pemphigoid (MMP) and review the literature. The cases were retrieved from the archives of Ondokuz Mayis University and Gülhane Military Medical Academy, Turkey, between 1997 and 2002. Inclusion criteria were clinical findings of oral MMP verified by histological and immunofluorescent examination. Thirteen patients (two males and 11 females), aged 16–72 years, were identified. Involvement was confined to the mouth in all cases except one, in which the conjunctiva was also affected. Two individuals in the study were < 20 years old, an age group rarely affected. The oral mucosa is often the initial site of MMP lesions, so it is important that dentists as well as physicians are aware of the symptoms and signs. A swift diagnosis, made in consultation with other specialists such as ophthalmologists and dermatologists, is needed in order to prevent a delay in treatment.


Hematology ◽  
2021 ◽  
Vol 2021 (1) ◽  
pp. 331-340
Author(s):  
Theodosia A. Kalfa

Abstract Heterogeneous red blood cell (RBC) membrane disorders and hydration defects often present with the common clinical findings of hemolytic anemia, but they may require substantially different management, based on their pathophysiology. An accurate and timely diagnosis is essential to avoid inappropriate interventions and prevent complications. Advances in genetic testing availability within the last decade, combined with extensive foundational knowledge on RBC membrane structure and function, now facilitate the correct diagnosis in patients with a variety of hereditary hemolytic anemias (HHAs). Studies in patient cohorts with well-defined genetic diagnoses have revealed complications such as iron overload in hereditary xerocytosis, which is amenable to monitoring, prevention, and treatment, and demonstrated that splenectomy is not always an effective or safe treatment for any patient with HHA. However, a multitude of variants of unknown clinical significance have been discovered by genetic evaluation, requiring interpretation by thorough phenotypic assessment in clinical and/or research laboratories. Here we discuss genotype-phenotype correlations and corresponding clinical management in patients with RBC membranopathies and propose an algorithm for the laboratory workup of patients presenting with symptoms and signs of hemolytic anemia, with a clinical case that exemplifies such a workup.


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