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Upper Extremity
Fractures: discussion includes common fracture management issues with mechanism, evaluation and treatment plan
Shoulder: discussion includes impingement syndrome, rotator cuff pathology, instability, labral tears, internal impingment, bicep pathology and periscapular contributors
Elbow: discussion includes little league elbow, UCL tears, ulnar nerve entrapment, medical epicondylitis and posterier impingement
Wrist/hand: discussions include tendonopathies, nerve impingments, avascular necrosis of bone, physeal injuries (gymnasts wrist), impingement syndromes, fractures and ligamentous instability.
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Upper Extremity Neurologic Injuries
The following neuropathies will be reviewed for etiology, diagnostic considerations including imaging and EMGs as well as treatment options both conservative and surgical:
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- Thoracic outlet syndrome
- Proximal neuropathies: Parsonage-Turner, spinal accessory, neuropathy
- Long thoracic N, suprascapular N, axillary N, ulnar N, median N, radial N
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Spine
Cervical: discussions include congenital abnormalities, growth considerations, fractures, acute neuropraxias, transient quadriparesis, disc pathology, facet syndrome, instability and myelopathy.
Thoracolumbar: Macro and micro trauma including adolescent and adult disc pathology as well as spondylolysis, apophysitis, scoliosis, kyphosis and lordosis.
Pelvis: discussions include labral and internal pathology, tendonopathies about the hip, sports hernia, femoral and inguinal hernias, osteitis pubis, local neuropathies, intrapelvic considerations, snapping hip, CAM and Pincer impingment, inflammation and infection. Pediatric considerations will include SCFE, AVN, infection and inflammation.
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Lower Extremity
Fractures: pathology includes common fracture management, issues with mechanism, evaluation and treatment plan.
Knee: pathology includes cartilage loss, meniscal injury, varus/valgus instability, ACL (including female ACL issues, prevention, controversies in repair), patella-femoral issues (including compression syndrome, instability, plica, Hoffa fat pad, quadricep tendonosis, patella tendonosis), popliteal cyst, arthritis, tendonpathies about the knee. Pediatric considerations include discoid meniscus, ACL repair, fractures and physeal injuries.
Calf: stress fractures, MTSS, tendonitis, compartment syndrome.
Ankle: pathology includes fractures, instabilities, tendonopathies, anterior and posterior impingement and nerve impingement. Pediatric considerations include tarsal conditions, tethered cord, congenital abnormalities.
Foot: pathology includes fractures and instabilities, congenital abnormalities, stress fractures.
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Neuropathies of the Lower Extremities
Adolescent Development: limb length, sketetal maturation, variants
On Field Management of the Athelete: airways, AED, spine board
Locker Room Medicine: suturing, RTP same game
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Medical Issues
Concussions: understanding of the acute recognition and evaluation of concussion along with utilization of sideline assessment tools and IMPACT testing for more prolonged symptoms.
HEENT: the recognition of injuries about the face including laceration management, nasal and facial fractures, auricular hematomas, tooth avulsion and eye trauma.
PPE: proficiency in performing on site athletic preparticipation evaluations including musculoskeletal and medical evaluation with particular attention to cardiac evaluation.
Cardiac Issues: understanding the recognition and evaluation of athletes with cardiac symptoms and understand RTP criteria.
Exercise Physiology: understanding of the cardiopulmonary aspects of exercise physiology including V02 max, exercise testing, pulmonary function testing and the relationship to the exercise prescription as well as utilization in the athlete with medical problems.
Pulmonary Issues: athletes with asthma, restrictive airway disease will be understood with treatment and RTP criteria.
Hormonal Issues in Athlete:
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- Diabetes: understanding of the insulin and glucose requirements of the diabetic athlete as well as the evaluation of treament options.
- Disordered eating and bone health: understanding of the spectrum of the bulimic and anorexic athlete as well as understand the athlete with the caloric balance issues. Hormonal and bone health evaluation and treatment will be stressed. The multidisciplinary approach of medical, psychological and nutritional aspects will be addresssed.
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Infectious Disease in the Athlete: understanding of the implications of infection in the athlete including MRSA, mononucleosis, viral infections, skin infections such as herpes gladiatorum and Lyme disease.
Dematologic Issues in the Athlete: understanding of the recognition, evaluation and RTP criteria of dermatologic issues such as herpes gladiatorum, molluscum contagiosum, bacterial skin infections as well as inflammatory issues such as atopy and eczema.
Rheumatologic Issues in the Athlete: includines connective tissue disorders as they relate to cardiovascular considerations, inflammatory arthritis and spondyloarthropathy with respect of recognition of symptoms, laboratory evaluation and treatment options.
Steriods and ergogenic aids: understanding the positive and negative aspects of ergogenic aids as well as the legal evaluation and testing requirements by different sport governing organizations.
Hematologic Issues in the Athlete: understanding risks and prevention of thrombotic complications as well as the problems with inherited hematologic issues such as G6PD, sickle cell traits.
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Nutrition: knowledge of the essential micro and macronutrients, calorie counts and nutritional assessments.
Sports Psychology: emphasis on the recognition of psychologic stress in relation to sports injury and the need to address this in rehabilitation as well as utilizing psychologic evaluation and intervention in dealing with the athlete with disordered eating.
Chest and Abdominal Trauma in the Athlete: knowledge of the evolution of internal injury in the athlete sustaining trauma to the chest and abdomen.
Medicolegal Issues: familiarity with medicolegal issues in sports medicine and prevention of these problems including maintaining good patient rapport and excellent record keeping.
Biostatistics: attain a knowledge of basic biostatistics as well as the application to clinical research.
The primary care sports medicine fellows will attend the New England ACSM meeting, the annual ACSM meeting and the Team Physician Course by ACSM each year. The fellows will also attend the pulmonary sessions with Dr. Dawn Ericson.
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