The patient was a 15-year-old adolescent male who was referred to a physical therapist for a chief complaint of bilateral posterolateral lower-leg pain, which was worse in the right lower extremity than in the left. Due to findings that were concerning for a stress fracture, the patient was referred to a pediatric sports medicine physician. Subsequent radiographs revealed findings that were concerning for a stress fracture along the medial aspect of the midshaft of the right fibula.

J Orthop Sports Phys Ther 2013;43(1):29. doi:10.2519/jospt.2013.0401

KEY WORDS: lower leg, radiography

The patient was an 11-year-old competitive gymnast with a 6-month history of left anteromedial hip pain and an internal snapping sensation, after experiencing pain and a deep "pop" in her hip after performing a hip hyperabduction maneuver. Hip radiographs taken at the time of the injury were normal. Despite activity modification, the patientís symptoms persisted. The patient was then referred to an orthopaedic surgeon who ordered magnetic resonance imaging of the patient's left hip, which was interpreted as normal. The orthopaedic surgeon recommended conservative management by a physical therapist. Following 2 months of treatment by the physical therapist, strength testing of the left hip was normal; however, hip range-of-motion findings were unchanged, and the patient was not able to return to gymnastics secondary to persistent pain, prompting referral to the orthopaedic surgeon. A magnetic resonance arthrogram was obtained, which revealed a possible capsular perforation or partial detachment of the distal posterior insertion of the joint capsule of the left hip. Based upon the physical examination findings and results from magnetic resonance imaging, the orthopaedic surgeon recommended strict avoidance from gymnastics, as well as any lower extremity stretching or impact activities for 6 months.

J Orthop Sports Phys Ther 2010;40(11):761. doi:10.2519/jospt.2010.0418

KEY WORDS: gymnastics, magnetic resonance arthrogram, magnetic resonance imaging