Chest Pain In A Distance Track Athlete - Page #4
 

Working Diagnosis:
Spontaneous Pneumomediastinum

Treatment:
Recommended two weeks of rest and pain control with NSAIDs as needed.

Outcome:
Returned to running in district finals against recommendations at 11 days. Developed further chest pain. CT of the chest showed persistent pneumomediastinum without other abnormalities.
-Recommended further rest with gradual return to play.
-Returned to sport and prior level of activity without symptoms at three weeks.

Author's Comments:
There is no consensus on return to play guidelines for a spontaneous pneumomediastinum. This case supports both resolution of symptoms and radiographic resolution of mediastinal air prior to return to play with an athlete with sponatneous pneumomediastinum.

References:
Langwieler, T., Steffani, K., et al. Spontaneuos pneumomediastinum. Annals of Thoracic Surgery 2004; 78: 711-713.
Collins, R. K. Hammans crunch: an adventitious sound. Journal of Family Practice 1994:38:284
Mihos, P., Potaris, K. et al. Sports-related spontaneous pneumomediastinum. Annals of Thoracic Surgery. 2004; 78; 983-986

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