Best Practice Case Studies-Pediatric Issues

Pdf Summary

The text presents two case studies involving young athletes with sports-related injuries, focusing on the evaluation and diagnosis of elbow and shoulder pain.

<strong>Study Question #1</strong> involves a 13-year-old male baseball player presenting with right elbow pain. The pain has worsened over weeks, accompanied by a clicking sound when moving the elbow. X-rays reveal an area of lucency at the capitellum anteriorly. The diagnosis is Osteochondritis Dissecans of the capitellum, common in young, skeletally immature athletes, particularly pitchers, as it results from overuse and repetitive compressive loading of the elbow. Radiographs typically show localized lucency or fragmentation in the capitellum’s anterolateral aspect. Treatment involves rest or surgery if severe.

<strong>Study Question #2</strong> discusses a 17-year-old female volleyball player with left shoulder pain, worsening over six weeks. She exhibits a positive Neer test and scapular dyskinesia, with normal x-rays showing a type 1 acromion. The diagnosis is Internal impingement, affecting the supraspinatus and infraspinatus tendons compressed between the humerus’s greater tuberosity and the glenoid’s posterosuperior aspect. This type of impingement occurs during the cocking motion of hitting or throwing caused by repetitive use or muscle imbalances. Unlike other kinds, external impingement often involves structural abnormalities reflected in imaging or soft tissue changes seen on ultrasound, which are absent in this case. Treatment typically addresses any biomechanical dysfunction. 

Both cases underscore the role of early diagnosis and appropriate management to prevent further injury in young athletes, emphasizing rest and correction of biomechanical issues as early interventions.

Meta Tag

Concept Osteochondritis Dissecans

Concept Internal Shoulder Impingement

Concept Capitellum

Concept Overhead Athlete

Concept Elbow Radiograph

Edition 3rd Edition

Related Case 3rd Edition, CASE 44

Topic Pediatric Issues

Keywords

Osteochondritis Dissecans

Internal impingement

elbow pain

shoulder pain

young athletes

sports injuries

biomechanical dysfunction

rest

skeletally immature

diagnosis

3rd Edition

3rd Edition, CASE 44

Pediatric Issues

Internal Shoulder Impingement

Capitellum

Overhead Athlete

Elbow Radiograph