http://casereports.bmj.com This feed contains articles for BMJ Case Reports Subject Collection "Sports and exercise medicine" BMJ Case Reports http://casereports.bmj.com http://casereports.bmj.com/cgi/content/short/2013/may08_1/bcr2012008543?rss=1 We present a clinical case image of a 20-year-old man with a lump behind his knee. A radiograph taken in the emergency department demonstrated the classical appearance of an osteochondroma. Osteochondroma is the commonest skeletal neoplasm. Surgical excision results in symptom resolution in over 90% of patients. Smurthwaite, K. A. Barnard, E. 2013-05-08 doi:10.1136/bcr-2012-008543 Unusual solid mass in the popliteal fossa BMJ Publishing Group Ltd MAY08_1 2013 201200854 2013-05-08 CASE-REPORT http://casereports.bmj.com/cgi/content/short/2013/may02_1/bcr2013009541?rss=1 The incidence of open bicondylar Hoffa fractures is extremely rare. We report one such case of a 42-year-old woman who presented to the emergency department with an open injury over the knee. Imaging revealed bicondylar Hoffa fracture. The patient was taken up for debridement and internal fixation. Intraoperative findings included an entrapped patella between the fracture fragments and extensor mechanism disruption. Hoffas fracture was fixed with lag screws and patellar tendon repaired on to the inferior patella. The patient was started on early postoperative range of motion exercises. The fracture united at 12 weeks with 120{degrees} knee flexion at 2 year follow-up. Kini, S. G. Sharma, M. Raman, R. 2013-05-02 doi:10.1136/bcr-2013-009541 A rare case of open bicondylar Hoffa fracture with extensor mechanism disruption BMJ Publishing Group Ltd MAY02_1 2013 201300954 2013-05-02 CASE-REPORT http://casereports.bmj.com/cgi/content/short/2013/may02_1/bcr2013009832?rss=1 Description A fit and well 21-year-old man received a blow to the medial side of his knee while dancing in a pub. He became immediately non-weight-bearing and attended the emergency department. On examination, his knee was held in partial flexion and there was a palpable hard mass lateral to the lateral femoral condyle (figure 1). Radiographs demonstrated a lateral patella dislocation (figure 2). Despite giving the patient 20 mg of intravenous morphine, several litres of entonox and 20 mg of midazolam, the emergency department and orthopaedic on-call teams could not reduce the patella. The patient was taken to theatre the next day where an attempt at closed reduction under general anaesthesia and a muscle relaxant also failed. A medial parapatellar incision allowed access to the knee joint. Manual exploration of the joint revealed that the patella was impacted against the lateral fem ... Yerimah, G. Eisenstein, N. Turner, R. 2013-05-02 doi:10.1136/bcr-2013-009832 Irreducible lateral dislocation of patella BMJ Publishing Group Ltd MAY02_1 2013 201300983 2013-05-02 CASE-REPORT http://casereports.bmj.com/cgi/content/short/2013/apr29_1/bcr2012008308?rss=1 We describe a case of simultaneous bilateral anterior shoulder dislocation in a 70-year-old gentleman post-trauma. There was no associated motor, sensory or vascular deficit. Patient underwent closed reduction for both his dislocated shoulder joints under general anaesthesia followed by immobilisation for 4 weeks, and subsequent follow-up showed good functional outcomes. Nourredine, H. El Sayad, M. Gull, S. Davies, A. P. 2013-04-29 doi:10.1136/bcr-2012-008308 Bilateral anterior shoulder dislocation BMJ Publishing Group Ltd APR29_1 2013 201200830 2013-04-29 CASE-REPORT http://casereports.bmj.com/cgi/content/short/2013/apr16_1/bcr2012007763?rss=1 Description Subtalar dislocations are rare types of injury and account for approximately 1% of all dislocations. There is simultaneous disruption of both the talocalcaneal and talonavicular joints, whereas the tibiotalar and calcaneocuboid joints remain undisturbed. Medial subtalar dislocations are the most common (up to 85%), with lateral types making up the majority of the rest.1 2 Total anterior or posterior dislocations are extremely rare. These injuries may be associated with fractures of the bones of the foot and ankle. Reviewing the literature reveals no previous reports of posterior talar process and navicular fracture, in the presence of a total medial subtalar dislocation (as in this case). Fotiadis et al3 have reported on a medial subtalar dislocation with non-displaced fractures of the talar body and navicular (figure 1 ... Eisenstein, N. Hillier, D. Ahmad, S. 2013-04-16 doi:10.1136/bcr-2012-007763 Medial subtalar dislocation with navicular and posterior talar process fracture: the first report in the literature BMJ Publishing Group Ltd APR16_1 2013 201200776 2013-04-16 CASE-REPORT http://casereports.bmj.com/cgi/content/short/2013/mar26_1/bcr2012007463?rss=1 ObjectiveTo evaluate the effect of combining photo-activation therapy with platelet-rich plasma injections for the novel treatment of osteoarthritis. DesignWe present a case report of osteoarthritis of the knee treated with photo-activated platelet-rich plasma injections (PAPRP). MethodsAfter utilising conventional osteoarthritis treatment methods a patient underwent a course of PAPRP injections. The patient outcome was measured using the numerical pain rating scale (NPRS) and the Western Ontario and McMaster Universities Arthritis (WOMAC) Index. ResultsFollowing treatment the patient reported improvements in both pain and function as measured by the NPRS and WOMAC Index, respectively. The patient was followed up for 18 weeks, at which time no significant complications were noted. ConclusionsIn this case report of osteoarthritis, with strict control of conventional therapy variables, PAPRP injections demonstrated improvement in all recorded outcome measures. The results of this case report highlight the need to further investigate the use of PAPRP in the treatment of symptomatic knee osteoarthritis. Freitag, J. B. Barnard, A. 2013-03-26 doi:10.1136/bcr-2012-007463 To evaluate the effect of combining photo-activation therapy with platelet-rich plasma injections for the novel treatment of osteoarthritis BMJ Publishing Group Ltd MAR26_1 2013 201200746 2013-03-26 CASE-REPORT http://casereports.bmj.com/cgi/content/short/2013/feb20_1/bcr2012008120?rss=1 We report three cases of adolescent boys with mild diplegic cerebral palsy (CP) who suffered disruption of the knee extensor mechanism. Two had fractures of the patella and the third a fracture avulsion of the tibial tubercle combined with an undisplaced fracture of the patella. All three had gait analysis prior to sustaining the fractures and were known to have mild knee crouch. Each participated in sport including football. Each suffered an acute deterioration in gait resulting in a referral for repeat gait analysis, and x-ray of the affected knee. With the increased involvement of children with CP in sporting activities, especially children with mild knee crouch, we caution that knee extensor rupture might be an increasing problem. Elhassan, Y. O'Sullivan, R. Walsh, M. O Brien, T. 2013-02-20 doi:10.1136/bcr-2012-008120 Knee extensor disruption in mild diplegic cerebral palsy: a risk for adolescent athletes BMJ Publishing Group Ltd FEB20_1 2013 201200812 2013-02-20 CASE-REPORT http://casereports.bmj.com/cgi/content/short/2013/feb07_1/bcr2012008189?rss=1 This article discusses a case in which ultrasound was the primary modality for diagnosis of traumatic patellar tendon rupture. Traditionally, this diagnosis has been made using MRI. This case highlights the growing need for emergency medicine physicians to become facile with bedside ultrasound and its indications as a supplement to traditional musculoskeletal examination. Normal and pathological patellar tendon examinations with ultrasound are discussed in detail. Furthermore, the advantages of ultrasound over the more traditional imaging modalities of x-ray and MRI in cases where tendon rupture is suspected are discussed. Berg, K. Peck, J. Boulger, C. Bahner, D. P. 2013-02-07 doi:10.1136/bcr-2012-008189 Patellar tendon rupture: an ultrasound case report BMJ Publishing Group Ltd FEB07_1 2013 201200818 2013-02-07 CASE-REPORT http://casereports.bmj.com/cgi/content/short/2013/jan29_1/bcr2012007662?rss=1 Two female doctors who were undergoing officer training at the Royal Military Academy Sandhurst sustained pubic ramus stress fractures. This report looks at the reasons why these medical officers may have sustained these fractures and how they may be prevented in future. Eisenstein, N. M. 2013-01-29 doi:10.1136/bcr-2012-007662 A tale of two pelvises BMJ Publishing Group Ltd JAN29_1 2013 201200766 2013-01-29 CASE-REPORT http://casereports.bmj.com/cgi/content/short/2013/jan28_1/bcr2012007370?rss=1 This study represented a unique opportunity to understand changes in the human motion biomechanics during basic locomotion within a time interval of 4 years, when the monitored individual regained his original aerobic fitness, running performance and body mass index as prior to the injury. The participant visited the laboratory a month prior to the injury and during 4 years after the surgery. The surgery, subsequent rehabilitation and a 4-year running training programme in the studied recreational athlete did not completely eliminate the consequences of the Achilles tendon rupture. The function muscle deficit is namely manifested by a lower net plantar flexion moment and a lower net-generated ankle joint power during the take-off in the stance phase. The greater dorsal flexion in the affected ankle joint at the first contact with the ground and consequently higher peaks of ground reaction forces during running are consequences of the longer Achilles tendon in the affected lower extremity and weakened calf muscles. Jandacka, D. Zahradnik, D. Foldyna, K. Hamill, J. 2013-01-28 doi:10.1136/bcr-2012-007370 Running biomechanics in a long-term monitored recreational athlete with a history of Achilles tendon rupture BMJ Publishing Group Ltd JAN28_1 2013 201200737 2013-01-28 CASE-REPORT