Introduction AAOS, AOSSM, AFP, and AAP have collaborated to form the "Preparticipation Physical Examination Task Force" Goal is to identify conditions that may predispose an athlete to injury or illness. often is the only medical encounter for adolescent athletes that don't have routine physician check-ups Should be performed in all athletes Legal necessity for high school and collegiate participation Orthopaedic history and questionnaire most useful tool for identifying musculoskeletal problems identifies 75% of problems should include complete list of current and past illnesses and injuries along with prior treatments all current OTC and prescription medications and supplements should be listed family history and past symptoms are paramount for identifying potentially lethal conditions document instances of only a solitary remaining organ in a paired-organ system (e.g., single kidney, single enucleation). Physical examination height, weight, and body mass index (BMI) , vital signs visual acuity lung exam musculoskeletal exam with focus on regions of prior injury or surgery male genital examination for inguinal hernia, testicular mass, and undescended testis scoliotic curve EKG's, urinalysis, CBC, ferritin, or chest radiographs presently not indicated for routine screening in the USA athletes are then assigned one of the following: clearance without restriction cleared with further evaluation recommended cleared with restrictions not cleared for participation Examination Red flags Exertional dizziness Diastolic murmurs, systolic murmurs (grade 3 or greater) Cardiac murmur worse with valsalva (may indicate HOCM) History of transient quadaplegia Illegal supplement use Heat-related illness Hypertension (> 140/90) Female athleteic triad in females may manifest as stress fracture, amenorrhea, or anorexia Cardiac Screening History hypertrophic cardiomyopathy, sudden death, murmurs, marfan syndrome, long QT syndrome athletes who suffer a sudden cardiac death most commonly have no history of prodromal symptoms Physical exam exertional symptoms with activity may include dyspnea, angina, dizziness, palpitations cardiac murmur that increases with valsalva indicates hypertrophic cardiomyopathy participation contraindicated with outflow obstruction Neurologic Screening History concussions, loss of consciousness, seizures, transient quadriplegia Physical exam neuropsychiatric testing at baseline is encouraged to serve as comparative data post-head injury