Understanding noninguinal abdominal hernias in the athlete.

Abdominal hernias are common with over 20 million hernia repairs performed worldwide. Inguinal hernias are the most common type of hernia. Inguinal and sports hernia have been discussed at length in recent literature, and therefore, they will not be addressed in this article. The noninguinal hernias are much less common but do occur, and knowledge of these hernias is important when assessing the athlete with abdominal pain. Approximately 25% of abdominal wall hernias are noninguinal, and new data show the order of frequency as umbilical, epigastric, incisional, femoral, and all others (i.e., Spigelian, obturator, traumatic). Return-to-play guidelines need to be tailored to the athlete and the needs of their sport. Using guidelines similar to abdominal strain injuries can be a starting point for the treatment plan. Laparoscopic repair is becoming more popular because of safety and efficacy, and it may lead to a more rapid return to play.

Testicular conditions in athletes: torsion, tumors, and epididymitis.

Individuals involved in sports are at risk for sustaining various injuries. In addition to musculoskeletal complaints, male athletes are at risk of incurring testicular injuries. These issues can range from an acute emergency such as testicular torsion to indolent testicular tumors. In contrast, epididymitis can present in stages. Presentation and management of testicular complaints can vary depending on the condition. Physicians who provide medical care to athletes need to be competent in diagnosing and managing testicular injuries.

Freiberg's Infraction in an Adolescent Dancer: Condition Often Mistaken for a Stress Fracture.

Freiberg's infraction is not widely seen but can occur among young athletes. Its symptoms and radiographic signs may mimic stress fractures, as in the 12-year-old female dancer described here. This condition, an osteochondrosis that most commonly affects the second metatarsal, is diagnosed with plain radiography. Treatment typically involves immobilization or off-loading to eliminate pain, use of orthoses, and a gradual return to weight-bearing activity.

Needs assessment of family medicine residency programs and predoctoral directors.

BACKGROUND AND OBJECTIVES: Both predoctoral directors and residency program directors are invested in the education of students in family medicine. However, the perspectives and goals of each group can be diverse. Improved collaboration between these groups of educators would be anticipated to enhance the education of students in family medicine, allow for greater interaction between family medicine resident and faculty physicians and students, and eventually entice more students to enter family medicine as a career. METHODS: We conducted a survey of family medicine residency program directors and predoctoral directors to assess the views of the members of each group on how they could be useful to the other group, how the other group could be more useful to them, and what the barriers are to successful collaboration. The survey was open for 1 month, and the response rate was a little over one third from both groups. RESULTS: We found that each group values its counterpart and finds them important in enhancing the success of family medicine, improving students' perceptions of family medicine, and attracting students to the field. The amount of contact between program directors and predoctoral directors is directly related to their geographical proximity. CONCLUSIONS: A collaborative effort between family medicine residency programs and predoctoral directors could increase medical students' interest in family medicine. The biggest barrier to an effective relationship is the perception of a lack of sufficient time to devote to improving the relationship.