ABSTRACT
Osteochondritis dissecans (OCD) should be considered in young, active patients who have generalized or anterior knee pain. A careful physical exam includes a Wilson test, thigh girth measurements, diagnostic tunnel view radiographs, and other imaging studies as needed for grading and prognosis. Two case reports demonstrate the signs and symptoms of OCD. Treatment by primary care physicians with sports medicine training may be conservative if lesions are medial and in situ and if patients are not skeletally mature; otherwise, referral is advised. Prompt surgical treatment is generally successful.
ABSTRACT
This article provides the practicing physician with an account of the commonly used ergogenic substances. Specific agents discussed include the following: stimulants, narcotic analgesics, anabolic-androgenic steroids, beta-blockers, diuretics, growth hormone, other peptide hormones, blood doping, and erythropoietin.
Subject(s)
Doping in Sports , Adrenergic beta-Antagonists/adverse effects , Adrenergic beta-Antagonists/pharmacology , Anabolic Agents/adverse effects , Anabolic Agents/pharmacology , Analgesics, Opioid/adverse effects , Analgesics, Opioid/pharmacology , Animals , Central Nervous System Stimulants/adverse effects , Central Nervous System Stimulants/pharmacology , Diuretics/adverse effects , Diuretics/pharmacology , Doping in Sports/classification , Doping in Sports/legislation & jurisprudence , Doping in Sports/prevention & control , Drug Prescriptions , Erythropoietin/adverse effects , Erythropoietin/pharmacology , Growth Hormone/adverse effects , Growth Hormone/pharmacology , Humans , Sports/legislation & jurisprudence , Sports Medicine/legislation & jurisprudence , Sports Medicine/methodsABSTRACT
Hypothyroidism usually presents insidiously with symptoms such as fatigue, cold intolerance, and weight gain. Less common findings include myalgia, arthralgia, and joint effusion. In the patient described here, a triathlete, interpretation of early signs and symptoms as typical tendinitis led to months of treatment failure. Considering hypothyroidism in the differential diagnosis for patients who have overuse syndromes can expedite treatment. Definitive diagnosis rests on testing of serum thyroid hormone levels. Treatment, which is usually quickly effective, consists of gradually adjusted thyroid hormone replacement.
ABSTRACT
Osteochondritis dissecans is a disorder in which a fragment of cartilage and subchondral bone separates from an articular surface. The etiology is uncertain, although trauma and ischemia have been implicated. The knee is most commonly affected, but the elbow and ankle may also be involved. Patients typically present during their adolescent or early adult years with nonspecific knee pain and swelling that worsens with activity. The diagnosis is confirmed by radiographic findings. Management decisions are based on the patient's age and the stability, location, and size of the lesion.
