Greater trochanteric pain syndrome: more than bursitis and iliotibial tract friction.

Disorders causing lateral hip pain are encountered frequently by physicians. Evaluating these problems can be challenging because of the myriad of potential causes, the complex anatomy of the peritrochanteric structures, and the inconsistently described etiologic factors. Misconceptions about the causes of lateral hip pain and tenderness are common, frequently leading to approaches that only provide temporary solutions rather than address the underlying pathology. Trochanteric bursitis is implicated frequently but is seldom the primary cause of pain in chronic cases. It is important to address hip rotator cuff tendinopathy and pelvic core instability. Treatment options include therapeutic exercise, physical modalities, corticosteroid injections, extracorporeal shock wave therapy, and regenerative injection therapies. For recalcitrant cases, surgery may be appropriate. By understanding the anatomy of the peritrochanteric structures, and the pathologic processes most likely responsible for symptomatology and dysfunction, the physician will be prepared to provide effective long-term solutions for this common problem.

Sports Medicine: Sports Event Care and Return to Play.

In 2008, approximately 60 million children, adolescents, and young adults were involved in organized sports, which account for more than 3.5 million injuries each year. Family physicians often create and implement return to play (RTP) protocols for athletes. If a concussion is suspected in an athlete, the athlete should be withdrawn immediately from participation in sports and monitored with serial assessments. There is no same-day RTP for athletes with concussion. A brief period of physical and cognitive rest is suggested, with a gradual return to activity. Transient brachial neuropraxia, also known as a burner or stinger, results from injury to the brachial plexus and typically resolves within days. Strict protocols exist for college and high school athletes with bacterial, viral, and fungal skin infections. Athletes may RTP when no new active lesions are present, healing lesions are covered, and the athlete is receiving treatment. Provision of care at a mass participation event requires extensive preparation. Emergency action plans are an invaluable tool for large sports events. These should be jointly developed by all involved parties and rehearsed regularly. Legal, liability, and privacy considerations may affect the physician's decision to provide care at a sports or mass participation event.

Postoperative Lyme Arthritis in the Orthopaedic Patient.

CONTEXT: Lyme disease is the most common tick-borne illness in North America and Europe, and Lyme arthritis is a frequent late-stage manifestation in the United States. However, Lyme arthritis has rarely been reported as a postoperative complication. EVIDENCE ACQUISITION: The PubMed database was queried through June 2018, and restricted to the English language, in search of relevant articles. STUDY DESIGN: Clinical review. LEVEL OF EVIDENCE: Level 3. RESULTS: A total of 5 cases of Lyme arthritis as a postoperative complication have been reported in the literature. CONCLUSION: These cases highlight the importance for providers practicing in Lyme-endemic regions to keep such an infection in mind when evaluating postoperative joint pain and swelling. We propose herein an algorithm for the workup of potential postoperative Lyme arthritis. STRENGTH OF RECOMMENDATION TAXONOMY (SORT): C.