Sports medicine training and practice opportunities for emergency physicians.

BACKGROUND: There is growing interest among emergency physicians to seek additional training in Sports Medicine (SM) and to add it to their clinical practice. This presents unique training and practice management issues. The majority of Primary Care SM fellowship programs list that they will accept emergency physicians, and approximately one-third have already had an emergency physician as an SM fellow. OBJECTIVES: The objective of this article is to provide an overview of the key elements for emergency physicians to consider as they pursue SM career goals. DISCUSSION: Training needs such as continuity of care as it pertains to the athlete, SM skills development, and practice management are reviewed. Practice challenges such as malpractice insurance and billing issues are discussed. Examples of several practice models are presented. Evolving trends in SM practice and training opportunities for emergency physicians are discussed as well. CONCLUSIONS: Sports Medicine is a viable career option for emergency physicians and may complement their skills set in the management of acute injuries. Practice and training opportunities will continue to evolve as this pathway into the practice of SM gains further recognition.

The international athlete--advances in management of jet lag disorder and anti-doping policy.

To perform at the highest level of international competition, athletes need to maximize rest during long travel, and expeditiously overcome the detrimental effects of "jet lag" (JL). The negative effects of JL may be alleviated by adopting a multimodality approach, including the judicious use of melatonin and other pharmacologic agents to aid re-entrainment and improve sleep characteristics. Strict compliance with anti-doping policy is pivotal before and during competition. There have been several recent updates regarding the use of selected medications, which mandate constant vigilance by sports medicine personnel to both evaluate drug efficacy and judiciously prescribe approved medications. It is critical that medical staff maintain familiarity and awareness on a continual basis to effectively educate athletes and support staff.

Pelvic tumor presenting as chronic back pain in a young adult.

A large proportion of Emergency Department visits are for chronic pain, specifically for chronic back pain. Often this entity requires minimal diagnostics. However, certain populations and presentations require a higher vigilance and a more detailed evaluation. This report describes the clinical presentation of a young adult with chronic back pain who exhibited new symptoms and subtle examination findings that expedited the ultimate diagnosis of pelvic chondrosarcoma.