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Adult Sports Medicine

This rotation revolves around outpatient clinics at Cardinal Orthopedics.  Cardinal Orthopedics is a large multi-specialty orthopedic group.  The fellow will see a wide base of patients, in the adult setting, with acute and chronic musculoskeletal needs.  Learning conservative treatment management, becoming proficient in joint injection principles, as well as recognizing indication for surgical treatment will be emphasized in the curriculum.  As in pediatric sports medicine rotations, the fellow will be exposed to a wide range of diagnoses in musculoskeletal medicine ranging from sports injury, injury prevention education, and formulation of wellness programs for the prevention of disease and treatment of chronic disease (i.e. coronary artery disease, DM, COPD).

Pediatric Orthopedics

The pediatric orthopedic rotation is supervised by our pediatric orthopedists.  This rotation will expose the fellow to a wide array of orthopedic issues seen in pediatrics (i.e.  SCFE, Legg-Calve’-Perthes disease, clubfoot, metatarsus adductus, outtoeing/intoeing, developmental dysplasia of the hip, aneurismal bone cysts to name a few).  As well, the fellow will gain confidence in radiographic evaluation of fractures, reduction techniques in fracture care, casting/splinting, and overall management of fractures.  This will be accomplished by rotating with our orthopedic specialists and taking 3 months of call with the orthopedic residents to learn how to hone these skills.

Orthopedic Spine and Physical Medicine & Rehabilitation

This rotation is comprised of two parts.  The first part of the rotation will be focused on spinal conditions in orthopedics.  The fellow will participate in the care of a wide array of spinal issues revolving around scoliosis, complicated spondylolysis/spondylolisthesis, cervical injury, lumbar disk disease, scheuermann’s disease, diskitis, and osteomyelitis.  This part of the rotation is supervised by orthopedic spine specialists.

The physical medicine and rehabilitation portion of the rotation will allow the fellow to become familiar with the latest theories of rehabilitation for acute and chronic medical problems affecting the musculoskeletal system, nervous system (including traumatic brain injury).  The fellow will obtain an understanding of basic principles and indications for commonly performed procedures in PM&R, including EMG studies and compartment pressure testing. They will also garner experience in treating chronic pain patients.

Orthopedic Hand

During the hand rotation, the fellow will rotate with or our orthopedic hand specialists.  The fellow will become proficient in treating hand and wrist injuries as well as fractures.  The fellow will gain experience and confidence in recognizing injuries that require more specialized care or surgery revolving around entrapment neuropathies, sprains/strains, tendonitis/bursitis, common fractures and dislocations, Dupuytren’s contracture, soft tissue injuries, flexor tendon nodules, arthritis, and overuse injuries.

Orthopedic Foot and Ankle

This rotation will allow the fellow to spend time treating patients with foot and ankle injuries needing more specialized care or surgery.  The fellow will be proficient in treating common foot and  ankle conditions affecting athletes; including fractures, stress fractures, lisfranc injury, sprains, sesamoiditis/sesamoid dysfunction, cysts, neuromas, hallux rigidus, intoeing, outtoeing, tendon injury/dysfunction/tendonitis, Sprains/strains, dislocations, Tarsal Tunnel Syndrome, arthritis, diabetic foot, heel pain/plantar fasciitis, toe deformities, bunions, corns and calluses, metatarsalgia, soft tissue masses of the foot and ankle.

Cardiology and Stress Testing

During the cardiology rotation the fellow will become comfortable with the cardiovascular evaluation with specific emphasis placed on recognition and identification of murmurs by auscultation.  The fellow will learn to recognize pathologic murmurs versus innocent murmurs.  The fellow will understand the cardiac evaluation for the pre-participation physical as well as screening questions proposed by ACSM and AHA.  The fellow will become comfortable with recognizing the epidemiology, diagnostic and screening tests, treatment options, and criteria for sports participation for causes of SCD.

The fellow will come to understand recommendations for obtaining EKG and echocardiogram as well as these test’s limitations in preventing sudden cardiac death (SCD).  The fellow will understand the phenomenon of Athletic Heart Syndrome and how to differentiate this entity from Cardiomyopathy.  The fellow will become familiar and comfortable with utilization of the Bethesda Criteria for sports participation decisions concerning cardiac diseases.  The fellow will be exposed to various forms of congenital heart disease and what limitations may pertain to athletic participation; as well as how to structure a safe cardiac rehab for these disease processes.  The fellow will become comfortable with recognition of abnormal blood pressure in a pediatric and adolescent population as well as understand the workup for secondary causes of elevated blood pressure in this patient population.  As well the fellow will be comfortable with initiation of proper treatment and chronic follow up for hypertension.  The fellow will also become proficient at the workup for chest pain in an athlete while learning to use such diagnostic tools as cardiac and pulmonary stress testing.

Musculoskeletal Radiology

This rotation will be one half month in duration.  However, the fellow will garner experience with regular sessions, throughout the year, reading films with musculoskeletal radiologists.  In addition, the fellow will meet monthly with sports medicine faculty and radiologists for radiology rounds.  During sessions, the fellow will gain an appreciation for the various radiologic musculoskeletal diagnostic tests and understand their limitations, sensitivity, specificity, and indications in relation to musculoskeletal medicine, as well as be aware of the costs of various diagnostic modalities, their advantages and disadvantages.  The fellow will also gain exposure to musculoskeletal pathology on plain films, CTs, MRIs, ultrasound, and bone scans, and will be able to correlate clinical findings of disease with radiographic abnormalities.

Rheumatology

The fellow’s rheumatology rotation will help to round out their musculoskeletal knowledge while learning to diagnose and initiate appropriate treatment for common rheumatologic problems until rheumatologic consultation can be obtained.  These disease processes will include but are not limited to rheumatoid arthritis, osteoarthritis, psoriatic arthritis, SLE, scleroderma, polymyositis and dermatomyositis, Kawasaki’s disease, PMR and giant cell arteritis, Sjogren’s syndrome, ankylosing spondylitis and the spondyloarthropathies, Reiter’s syndrome, sarcoidosis, infectious vs. inflammatory arthritis, gout and CPP disease, fibromyalgia and fibromyositis, Complex Regional Pain Syndrome, lyme disease, common vasculitides, and cryoglobulinemia.

Continuity Clinic

The fellow will spend one half day per week maintaining clinical competence in the fellow’s perspective primary field of primary care medicine.  This may include pediatrics, internal medicine and pediatrics, family medicine, or internal medicine.  The rotation will take place at the South High Street Internal Medicine and Pediatric Clinic.  For fellows, with primary certification in emergency medicine; special arrangements will be made to maintain clinical competence in the emergency department. 

Fellow Run Sports Medicine Clinic

The fellow will run, one half day per week, a designated Nationwide Children's Sports Medicine fellow’s clinic.  This will be a fully functional referral clinic focused on managing musculoskeletal/sports related injuries and issues.  One of the sports medicine faculty will precept the fellow in this clinic.

Learn about additional experience including Event Coverage, Conferences, and Scholarly Activity/Research.