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OVERLAND PARK, KANSAS: The American Medical Society for Sports Medicine (AMSSM) recently published a consensus statement in the July issue of the Clinical Journal for Sports Medicine entitled “Mononucleosis and Athletic Participation: An Evidence Based Subject Review”. Authors of the article include: Dr. Margot Putukian, Dr. Francis O’Connor, Dr. Paul Stricker, Dr. Christopher McGrew, Dr. Robert Hosey, Dr. Steven Gordon, Dr. James Kinderknecht, Dr. Vesna Kriss, and Dr. Gregory Landry. The authors reviewed the clinical presentation, as well as, evidence based conclusions about management and return to play guidelines for athletes with Infectious Mononucleosis (IM).
Sports medicine clinicians are often confronted with diagnosing IM and assessing for splenomegaly given the potential for splenic rupture. Research consistently demonstrates that physical examination alone should not be used to diagnose IM or guide considerations for return to play. Ultrasonography has been the imaging modality of choice to detect splenomegaly. However, one time imaging to evaluate for splenomegaly during acute illness is not recommended. The authors conclude that uncomplicated IM in athletes be treated with supportive care, reserving corticosteroids for complications. An athlete should be held from contact and noncontact exertional activities for a minimum of 3 weeks, due to the risk of splenic rupture. Return to play is then based on the individual patient's symptomatology.
The consensus statement lead author, Dr. Margot Putukian, is a past president of the AMSSM. She is currently the director of athletic medicine and head team physician at Princeton University. She is also an Associate Professor at Robert Wood Johnson Medical School-University of Medicine and Dentistry of New Jersey.
The American Medical Society for Sports Medicine (AMSSM) was organized in 1991 by physicians who recognized the need for an organization within the field of sports medicine that approached athletes, exercising individuals and teams comprehensively with consultative and continuous care of their orthopedic, medical, nutritional and psychosocial issues. Although sports medicine concepts are often thought of in conjunction with professional and elite athletes, these concepts apply to athletes of all levels including grade school, high school, college and recreational athletes. AMSSM is comprised of over 1000 Sports Medicine Physicians whose goal is to provide a link between the rapidly expanding core of knowledge related to sports medicine and its application to patients in a clinical setting.
NOTE: For more information, please contact the AMSSM, 11639 Earnshaw, Overland Park, KS 66210, (913) 327-1415.
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