4.1 of 20 Ratings
A 15-year-old male with trisomy 21 patient presents requesting orthopedic clearance to compete as a gymnast in the Special Olympics. He has already been cleared by both his cardiologist and endocrinologist. He has been treated in the past for an elbow dislocation as well as bilateral recurrent patellar dislocations but presently has no complaints. He denies any pain, difficulty ambulating, and reports that his training has been progressing well. Which of the following is recommended prior to participation?
AP pelvic radiograph
Imaging of both previously injured knees and elbow
Imaging of the cervical spine
Referral to a neurologist
The patient may be cleared for participation without further work-up
Select Answer to see Preferred Response
The parents of a 10-year-old boy with Down syndrome are seeking sports clearance for participation in the high jump at the Special Olympics. He is asymptomatic, and the neurologic examination is normal. The hips and patellae are clinically stable. Radiographs of the cervical spine in flexion and extension show a maximum atlanto-dens interval (ADI) of 6 mm. Based on these findings, what recommendation should be made?
Clearance for all sports activities
Avoidance of contact sports, high jump, and diving
Application of a hard cervical collar during sports events
Application of a halo vest
Posterior atlantoaxial arthrodesis