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"Medicina Sportiva" No.14 - 2008 The 15-th Sports Medicine Balkan Congress
INJURIES IN SPORTS


CLINICAL ASSESSMENT OF ANTERIOR TIGH PAIN AT PERFORMANCE ATHLETES

Oraviţan  Mihaela1, Vasilescu Mirela2, Avram Claudiu 1, Galoşi Lucian3
1 Physical Education and Sport Faculty, West University of Timisoara,
2 University of Craiova,
3 Rehabilitation Department, Emmergency Clinical County Hospital of Timisoara, Romania


The anterior thigh is the site of lot of injuries at performance athletes; the most common causes of this pain are presented in table 1.
Table 1. Anterior thigh pain etiology

Cause of anterior thigh painFrequency
Contusion of quadriceps femori muscle ***
Strain of quadriceps femori muscle ***
Myositis ossificans of quadriceps femori muscle ***
Referred pain (from hip joint, sacroiliac joint, lumbar spine) **
Strain of gracilis muscle **
Strain of sartorius muscle **
Femur stress fracture **
Avulsion of the rectus femori apophysis **
Perthes´ disease *
Tumor (osteosarcoma of the femur etc.) *
*** - common; ** - less common; * - rare

The clinical assessment of this symptom is based, like in other pain syndromes, on history of pain, on clinical examination and other investigations. The anamnesis must determine the mechanism of a potential injury, the evolution of pain, the presence of other symptoms, the functionality of lower limb, the medical measures that have been applied before (PRICE, AINS medication etc.). The clinical examination elements which are important to put a correct diagnosis are presented in table 2.

Table 2. Steps of clinical examination in anterior thigh pain

Inspection Standing, walking, supine
Palpation Subcutaneous, muscular tissues
Functionality Active movements: hip flexion, hip extension, knee flexion, knee extension
Passive movements: hip flexion, hip extension, knee flexion, knee extension, stretching of anterior thigh muscles
Resisted movements: knee extension, straight leg raises, hip flexion
Functional test: squat, jump, hop, kick
Special test: for femoral stress fracture, neural tension, lumbar spine, sacroiliac joint

Although, usually, anterior thigh pain does not require other paraclinical examinations, there are some investigations that may be done at these athletes: ultrasound, X-ray, isotopic bone scan or MRI. Because the treatment protocols for the pathologies manifested with anterior thigh pain are different, all these steps must be respected carefully.
Key words: anterior thigh, pain, athletes.





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