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Jones JC, Schultz C, Podvin C, Mikhail D, Radel LC. Point-of-Care Ultrasound (POCUS) for Sideline Youth Sports Coverage. Curr Rev Musculoskelet Med 2023; 16:493-500. [PMID: 37566361 PMCID: PMC10587036 DOI: 10.1007/s12178-023-09859-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/20/2023] [Indexed: 08/12/2023]
Abstract
PURPOSE OF REVIEW The purpose of this review is to discuss the use of point-of-care ultrasound for sideline youth sports coverage. RECENT FINDINGS Participation in youth sports has been increasing, with trends that athletes are specializing earlier and competing at higher levels at younger ages (NSCH 2019, Fabricant 2013). Point-of-care ultrasound (POCUS) utilizes non-invasive imaging to diagnose and manage various musculoskeletal conditions ranging from traumatic injuries, such as fractures and intramuscular hematomas, to early screening for conditions such as asymptomatic knee lesions. Since it is well-tolerated by children and adolescents and allows for easy accessibility for sideline care, POCUS could provide a strong alternative to other imaging modalities such as x-ray and magnetic resonance imaging (MRI) as both have their limitations. Youth sideline sports coverage could be enhanced with immediate medical attention from ultrasound-trained medical professionals. On the sidelines of a traumatic injury, POCUS expedites patient care with immediate examination of acute injuries. In low resource and hard-to-reach locations such as a rural youth sporting event, it can be key in the triaging of injuries. As a supplement to a physical exam, the risk of a misdiagnosis is reduced, and a long, expensive trip to the hospital for unnecessary imaging studies may be avoided. Ultrasound is a versatile, non-invasive, radiation-free imaging modality that serves as an accessible option for sideline coverage at youth sporting events. Ultrasound is well-tolerated by children and adolescents. It can be used to evaluate, diagnose, and manage a range of musculoskeletal conditions at the sidelines of youth sports.
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Affiliation(s)
- Jacob C. Jones
- Scottish Rite for Children, 5700 Dallas Pkwy Frisco, Dallas, TX 75034 USA
- University of Texas Southwestern Medical Center, Dallas, TX USA
| | - Cassidy Schultz
- Scottish Rite for Children, 5700 Dallas Pkwy Frisco, Dallas, TX 75034 USA
| | - Caroline Podvin
- Scottish Rite for Children, 5700 Dallas Pkwy Frisco, Dallas, TX 75034 USA
| | - David Mikhail
- University of Texas Southwestern Medical Center, Dallas, TX USA
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Worrall H, Podvin C, Althoff C, Chung JS, Sugimoto D, Stokes M, Radel LC, Cullum CM, Miller SM, Jones JC. Position comparison of sport-related concussions in female youth soccer players. PHYSICIAN SPORTSMED 2023:1-8. [PMID: 37564006 DOI: 10.1080/00913847.2023.2246869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/21/2023] [Accepted: 08/08/2023] [Indexed: 08/12/2023]
Abstract
OBJECTIVES Youth soccer participation, particularly among females, continues to grow worldwide. With the high incidence of sport-related concussion (SRC) in soccer, it is important to investigate if SRC occurs disproportionally by positions. Our hypothesis was to see no positional differences in SRCs, SRC-related characteristics, and outcomes among in female youth soccer athletes. METHODS Data were prospectively collected from participants at a single sports medicine institution between August 2015-April 2021. Female participants aged 8-18 diagnosed with SRC sustained during an organized soccer practice, scrimmage, or game were separated into 4 groups based on position: Forward, Midfielder, Defender, and Goalkeeper. Demographics, medical history, injury-related details, and outcomes were reviewed. A chi-square test or Fisher's exact test was used for categorical variables. Continuous variables were compared with Mann-Whitney or Kruskal-Wallis test. RESULTS Two hundred fourteen participants were included: 52 Forwards, 65 Midfielders, 63 Defenders, and 34 Goalkeepers. There were no significant differences between the groups in age, race, ethnicity, or previous concussion history. Differences in mechanism existed with Goalkeepers most commonly reporting Head to Body Part. Goalkeepers, which make up 1/11 of the total positions on the field, had a significantly higher proportion of SRCs compared to Field Positions. (9.1% vs 15.9%)At 3-month post-enrollment, there were no significant differences in reported symptoms or return-to-play between the different positions. CONCLUSION In youth female soccer players, goalkeepers sustained a higher proportion of sport-related concussions compared to field players based upon the composition of a soccer team. The mechanism of injury also differed among the different soccer positions. However, no differences in concussion characteristics, outcomes, or RTP were seen across the different soccer positions.
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Affiliation(s)
- Hannah Worrall
- Department of Orthopedics and Sports Medicine, Scottish Rite for Children, Frisco, TX, USA
| | - Caroline Podvin
- Department of Orthopedics and Sports Medicine, Scottish Rite for Children, Frisco, TX, USA
| | - Claire Althoff
- Department of Orthopedics and Sports Medicine, Scottish Rite for Children, Frisco, TX, USA
| | - Jane S Chung
- Department of Orthopedics and Sports Medicine, Scottish Rite for Children, Frisco, TX, USA
- UT Southwestern Medical Center, Dallas, TX, USA
| | | | - Mathew Stokes
- Department of Orthopedics and Sports Medicine, Scottish Rite for Children, Frisco, TX, USA
- UT Southwestern Medical Center, Dallas, TX, USA
| | - Luke C Radel
- Department of Pediatrics, Mayo Clinic, Rochester, MN, USA
| | | | - Shane M Miller
- Department of Orthopedics and Sports Medicine, Scottish Rite for Children, Frisco, TX, USA
- UT Southwestern Medical Center, Dallas, TX, USA
| | - Jacob C Jones
- Department of Orthopedics and Sports Medicine, Scottish Rite for Children, Frisco, TX, USA
- UT Southwestern Medical Center, Dallas, TX, USA
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Radel LC, Jones J, Garcia K, Soma D, Miller S, Sugimoto D. Pediatric Hurdle-Related Acute Injuries in Track and Field presenting to US Emergency Departments: Descriptive Epidemiology Study. PHYSICIAN SPORTSMED 2022. [PMID: 36043997 DOI: 10.1080/00913847.2022.2120371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
BACKGROUND Hurdling is a track event that is unique due to a combination of running and jumping over an apparatus. Since hurdling requires a special skillset with sprinting and jumping, athletes are at risk for various musculoskeletal injuries. However, there has been a paucity of studies describing the epidemiology of pediatric hurdle injuries. PURPOSE To examine hurdle-related injury types, injured body parts, injury mechanisms, and injury settings in children and adolescents. METHODS Descriptive epidemiology study. Data from the National Electronic Injury Surveillance System, which represents emergency room visits was retrospectively reviewed. Injury data involving hurdle injuries was searched during a 10-year period (2008-2017) with hurdlers 18 years of age and younger. Injuries were then classified based upon injury types, body parts, injury mechanisms, and injury settings. Descriptive statistics were used including mean ± standard deviation, frequency (N), and percentages (%). RESULTS A total of 749 hurdle-related injuries were found from 333 males (44.5%) and 416 females (55.5%). The top three injury types were traumatic fracture (N=218, 29.1%), joint sprain (N=191, 25.5%), and contusion/hematoma/bruise (N=78, 10.4%). The top three injured body parts were ankle (N=140, 18.7%), knee (N=120, 16.0%), and wrist (N=69, 9.2%). The most common injury mechanisms were apparatus-related trips, falls, and landings (N=594, 79.0%). Finally, injury settings consisted of track and field practices (N=469, 62.6%), track and field meets (N=96, 12.8%), and other settings including gym, physical education class, recess, school activities, and camps (N=49, 6.5%). CONCLUSION In pediatric hurdle athletes, the most prevalent injury type seen in the emergency room was fracture. Although most hurdle-related injuries occur in the lower extremity, injuries at the wrist were the 3rd most commonly injured body location. The most common injury mechanism was apparatus-related trip, fall, and landing, and injuries most commonly occurred during track practices. In pediatric hurdle athletes seen in the emergency room, majority of injuries consisted of traumatic fractures and joint sprains at ankle, knee, and wrist, which frequently occurred with apparatus-related trip, fall, and landing mechanisms during track and field practices.
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Affiliation(s)
- Luke C Radel
- Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA
| | - Jacob Jones
- Scottish Rite for Children, Dallas, TX, USA.,University of Texas Southwestern, Dallas, TX, USA
| | | | - David Soma
- Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA
| | - Shane Miller
- Scottish Rite for Children, Dallas, TX, USA.,University of Texas Southwestern, Dallas, TX, USA
| | - Dai Sugimoto
- Waseda University, Tokyo, Japan.,The Micheli Center for Sports Injury Prevention, Waltham, MA, USA
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Kobelski GP, Radel LC, Jones JC, O'Brien MJ, Meehan WP, Sugimoto D. Comparison of pre-high school and high school football quarterback injuries. PHYSICIAN SPORTSMED 2022:1-5. [PMID: 35612541 DOI: 10.1080/00913847.2022.2082854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To compare the common injuries of pre-high school American football quarterbacks (Pre-HS QBs) and high school American football quarterbacks (HS QBs) within the last 15 years. METHODS A retrospective chart review was performed at a sports medicine clinic at a tertiary-level pediatric medical center. Pediatric and adolescent American football quarterback patients who sustained sports-related injuries were extracted. Injury status (acute vs. overuse), injured anatomic locations, injury types, and surgical status were compared by Pre-HS QBs (<14 years old) and HS QBs (14-18 years old). RESULTS A total of 121 injuries were found in 118 male Pre-HS QBs (mean age: 12.4 ± 1.6), while 302 injuries were observed in 256 male HS QBs (mean age: 15.8 ± 1.4). Overall, nearly two-third (2/3) of injuries were acute (64.3%) while a little over one-third (1/3) of injuries were overuse in nature (35.7%), and there were no differences between Pre-HS and HS QBs (58.7% vs. 66.7%, p = 0.114). The top 3 injured anatomic locations for Pre-HS QBs were elbow (20.7%), shoulder (18.2%), and head/neck (14.0%). For HS QBs, the top 3 injured anatomic locations were shoulder (24.5%), knee (17.5%), and head/neck (15.2%). There were significant differences in proportion of elbow (20.7% vs. 10.6%, p = 0.006), hip/trunk/upper leg (10.7% vs. 3.3%, p = 0.002), and knee injuries (9.1% vs. 17.5%, p = 0.028) between Pre-HS and HS QBs. Pre-HS QBs had significantly more bony/cartilaginous/labral injuries than their older counterparts (60.3% vs. 46.3%, p = 0.009) while HS QBs experienced significantly more ligamentous injuries than Pre-HS QBs (14.2% vs. 5.8%, p = 0.015). CONCLUSIONS QB-associated injuries were distinctively different between Pre-HS and HS QBs. Future studies are warranted to investigate relatively high proportions of elbow injuries as well as bony/cartilaginous/labral injuries found in Pre-HS QBs.
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Affiliation(s)
- Greggory P Kobelski
- The Micheli Center for Sports Injury Prevention, Waltham, MA, USA.,Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA, USA
| | - Luke C Radel
- Division of Community Pediatric and Adolescent Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Jacob C Jones
- Department of Pediatric Sports Medicine, Scottish Rite for Children, Dallas, TX, USA.,Department of Orthopaedic Surgery, University of Texas Southwestern, Dallas, TX, USA
| | - Michael J O'Brien
- The Micheli Center for Sports Injury Prevention, Waltham, MA, USA.,Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - William P Meehan
- The Micheli Center for Sports Injury Prevention, Waltham, MA, USA.,Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Dai Sugimoto
- The Micheli Center for Sports Injury Prevention, Waltham, MA, USA.,Faculty of Sport Sciences, Waseda University, Tokyo, Japan
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Radel LC, Kobelski GP, O'Brien MJ, Meehan WP, Sugimoto D. Youth American football quarterback injuries: a descriptive study of 15 years of retrospective data. PHYSICIAN SPORTSMED 2020; 48:463-468. [PMID: 32228392 DOI: 10.1080/00913847.2020.1749907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objectives: To describe common injuries of youth American football quarterbacks (QBs) cared for in a regional sports medicine center within the last 15 years. Methods: A retrospective chart review of all male youth American football QB patients who sustained sports-related injuries at a regional pediatric medical center between 01/01/2003 and 10/01/2018. Patients were identified using HoundDog to search the term 'quarterback.' Records were then reviewed to identify all male QBs ≤ 18 years of age. Injures that were not a result of football participation were excluded. Main outcome variables were injured anatomic locations, injury types, surgical status, and settings in which the injury was sustained. Descriptive statistics were used to analyze the outcome variables. Results: A total of 374 QBs (mean age: 14.6 ± 2.1) sustained a total of 423 injuries. The top 5 injured anatomic locations were shoulder (22%), knee (15%) head/neck (14%), elbow (13%), and wrist/hand/lower arm (11%). Most injuries (64.3%) were acute; 35.7% were chronic in nature. Most acute injuries (55.5%) occurred during games. Of the chronic injuries, 47.0% occurred during off-season and 34.4% occurred in-season. Among all injuries, 22.9% were surgical cases, and the top 3 anatomic locations of surgery were knee (35.0%), shoulder (20.7%), and elbow (18.7%). Conclusions: The shoulder is the most commonly injured body part among young QBs seeking care in a regional pediatric medical center, although the knee is the most commonly injured body part that requires surgery. Most QB injuries are acute in mechanism and the majority of these acute injuries occur during games.
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Affiliation(s)
- Luke C Radel
- Division of Community Pediatric and Adolescent Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic , Rochester, MN, USA
| | - Greggory P Kobelski
- The Micheli Center for Sports Injury Prevention , Waltham, MA, USA.,Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital , Boston, MA, USA
| | - Michael J O'Brien
- The Micheli Center for Sports Injury Prevention , Waltham, MA, USA.,Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital , Boston, MA, USA.,Department of Orthopaedic Surgery, Harvard Medical School , Boston, MA, USA
| | - William P Meehan
- The Micheli Center for Sports Injury Prevention , Waltham, MA, USA.,Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital , Boston, MA, USA.,Department of Orthopaedic Surgery, Harvard Medical School , Boston, MA, USA
| | - Dai Sugimoto
- The Micheli Center for Sports Injury Prevention , Waltham, MA, USA.,Faculty of Sports Sciences, Waseda University , Tokyo, Japan
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Radel LC, Kobelski GP, O'Brien MJ, Meehan WP, Sugimoto D. Descriptive Analysis of Youth American Football Quarterback Injuries: A 15-years of Retrospective Data Study. Med Sci Sports Exerc 2019. [DOI: 10.1249/01.mss.0000562268.60470.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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