William O. Roberts

Knee Aspiration and Injection

Injection and aspiration of a knee joint is a useful procedure for the office, especially in a practice involving many physically active patients. Common reasons for aspirating or injecting a knee include local anesthesia, diagnosis of an unexplained effusion, evacuation of a painful effusion, and injection of a corticosteroid.

Tub Cooling for Exertional Heatstroke

For an athlete who has exertional heatstroke, every minute counts: Rapid cooling can mean the difference between walking away from the event medical area and being hospitalized with potential sequelae. The fastest and simplest way to cool a dangerously overheated athlete is to put him or her in an ice-water bath. This method reduces body temperature by an average of 17 degrees F an hour ((1)).

A silicone splint for auricular hematoma

Auricular hematomas are often encountered in a sports medicine practice, most commonly among wrestlers, but also in boxers, football and rugby players, and judo athletes.(1) A relatively new treatment, the use of a silicone splint, offers several advantages over other treatments with regard to the risk of recurrence, observation of the site, and return to competition.

Plantar Fascia Injection

Plantar fasciitis is a major cause of heel pain in athletes and active people. The pain can usually be controlled with conservative measures, such as stretching, the use of arch supports, night splinting, and short-term activity modification, which allow the injured tissue to heal. However, persistent cases sometimes require an injection of a corticosteroid and local anesthetic into the calcaneal origin of the plantar fascia to relieve pain and promote healing.

Keeping sports safe: physicians should take the lead.

The image is familiar and dramatic. An elite athlete is injured, and a sports medicine physician is at his or her side while the athlete is carried from the field or arena to the sidelines and perhaps to a waiting ambulance. Thousands in the stands and millions more in front of televisions watch the physician practicing sports medicine in a most public way and are reminded that sports participation is a risky business.

Subacromial space injection: pain reliever, diagnostic tool.

Some of the most common presentations in a primary care office relate to shoulder pain; disorders of the rotator cuff and potential look-alikes such as referred neck pain or acromioclavicular (AC) joint arthritis are chief among the causes. The differential diagnosis can be difficult, particularly among older patients. And, of course, patients want relief of pain. Subacromial space injection using anesthetic with or without corticosteroid can assist in both phases of management.

Hand-based thumb spica casting.

A hand-based thumb spica cast can be used to protect the metacarpophalangeal (MCP) and interphalangeal (IP) joints of the thumb after uncomplicated ulnar collateral ligament (UCL) sprains and certain other thumb injuries. The cast allows continued participation in many activities, letting the patient grip an implement and move the wrist joint but immobilizing the thumb joints.

Applying the Munster Cast: Optimal Motion Control for Scaphoid Fractures

The scaphoid is the most frequently fractured carpal bone, with fractures of the middle third accounting for 80% of all scaphoid fractures (1-3). These fractures are commonly treated with a thumb spica, long arm cast that immobilizes both the wrist and the elbow. This type of cast is cumbersome and creates economic hardship for some patients.