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This study addresses the epidemiology of injuries in adolescent male and female soccer players in Germany. Therefore, the purpose of the study was to analyse the injuries in male and female youth soccer players in Germany. This study was designed as a cross-sectional web-based survey. From March until December 2011 we investigated 1110 soccer players (male n = 841; female n = 269) aged 12 - 19 years (15.0 ± 2.0 years) from 60 clubs in Southern Germany. A total of 664 (79 %) of the 841 boys and 67 (25 %) of the 269 girls reported being injured due to soccer. The total number of injuries was 2373. Respectively the frequency of injury was 2.85 in boys and 7.10 in girls. The lower extremities were affected in 70 % of all reported cases. Strains were the most common injuries in the lower and upper extremities (35 %). The boys reported in 51.5 % of all injuries that the injury was non-contact in nature. In contrast, 52.1 % of the injuries in girls were reported as contact injuries. Similar amounts of injuries were observed in training versus games for both genders. Prevention procedures, such as a thorough warm-up, should be implemented before every game and training to reduce the risk of injury., (© Georg Thieme Verlag KG Stuttgart · New York.)

The introduction of the world's first Medical Desktop-Conference via public phone lines (ISDN-S2M) in spring 1994 for the weekly discussion of radiological findings with 25 orthopedic surgeons has proved the effectiveness of this system developed by the project BERMED. The use of standard hard- and software as well as ISDN are the most important factors to keep the system costs low. Technical advantages can be seen in the immediate, loss-free transmission of image and other patient-related data and in the integration of digital archives. Medical advantages are the 24-hour-availability of the radiologist and quality-control of the radiologists work. Practitioners and external hospitals can be tied closely to radiological service centers by using ISDNetwork.

MR studies of 41 patients with confirmed spondylitis were evaluated with regard to imaging findings resembling metastases or fracture. 30 patients had MR results considered typical for spondylitis (contiguous changes in two vertebrae and disc, soft tissue tumour). 11 patients had MR studies differing from this pattern. Absence of soft tissue involvement and discontinuous marrow changes may be misdiagnosed as bone marrow metastases.

MRI has grown increasingly important in recent years in diagnosis of degenerative disease of the cervical spine, due to improvements of method that have made it a valuable diagnostic tool. The following contribution gives a brief introduction to the pathophysiology of degenerative changes in the cervical vertebral column and to the indications for MRI, describing within the framework of imaging the present state of MR examination technique. The ranking of the various gradient echo sequences, of the 3D methods and of the administration of contrast media in cervical myelopathy and radiculopathy is discussed.

Allergic reaction following chemonucleolysis with chymopapain is responsible for half of all known complications of this treatment. Although the incidence of allergic reactions is comparatively low one should not underestimate the danger involved. If chemonucleolysis is performed under local anaesthesia, the risk of an anaphylactic reaction is reduced. If no pre-operative test methods are available, the patient risk can be considerably lessened by suitable premedication and by keeping anti-allergics within easy reach during intradiscal therapy. Exclusion of patients who have a previous history of allergy from chemonucleolysis will not result in additional safety. The specificity of the serological tests is very high, but their sensitivity and reliability in respect of prediction of an allergic reaction with positive or negative test result is comparatively low. They take up a lot of time (24 hours) and require skilled personnel trained in laboratory chemistry. The chymopapain prick test is simple to perform and the result of the test rapidly available (15 minutes). The danger of allergic reactions to the prick test itself is negligibly small, as experience has shown. At the present time no comparative tests are available between serological tests and skin tests in a large group of patients, so that we can say something about the reliability only on the basis of empirical data. Of the 352 test-negative patients investigated so far, none had an allergic immediate reaction to chymopapain. Even if we take the possibility of false positive skin tests into consideration, we believe that it would not be appropriate with a positive skin test to perform chemonucleolysis.

Chemonucleolysis with Chymopapain (Chymodiactin, Disease) bears the risk of unpredictable anaphylactic reactions. The rate of anaphylaxis is reported to be between 0.35 and 1.5%. Serological in vitro tests such as RAST (Radio Allergo Sorbent Test) or ChymoFAST (Fluorescent Allergo Sorbent Test) are used to determine increased specific IgE antibody titres against chymopapain in patients submitted to chemonucleolysis for lumbar disc disease. Alternatively skin prick tests have also been applied in clinical trials. A skin prick test including Discase, Chymodiactin and Solutrast 250 M, which is a radiopaque dye used for discography, has been performed in a total of 208 patients. One-hundred and seventy-seven patients were tested before, 31 patients were tested after chemonucleolysis with chymopapain. From the group tested before chemonucleolysis, 2.3-3.5% had positive skin testes. After chemonucleolysis, the overall allergy rate to chymopapain increased to 41.9%. Positive skin reactions seem to be time-dependent: Between the 3rd and 12th week after chemonucleolysis more than 70% of the patients had positive skin tests. There was no correlation between a history of previous allergy and the skin test result. Patients with positive skin tests should be excluded from chemonucleolysis. This procedure increases the safety for patients submitted to chemonucleolysis. No anaphylactic reaction has been observed hitherto in nearly 350 patients who were treated with the intradiscal injection of chymopapain following a negative skin prick test.

Degenerative diseases of the lumbar vertebral discs or the vertebral joints are the main causes of low back pain and sciatica following overstraining during sports activities. However, they are rarely seen in sportsmen engaged in competitive sports because these persons are mostly young and well-trained. Other neurological diseases are even rarer as possible causes of sciatica. That is why we report on a young athletic who is a short-distance hurdler (110m hurdle race) and has been suffering from a neurinoma of the spinal nerve root L3 with sciatica and pain in the knee as initial symptoms. Attention is drawn to the importance of neurological examinations as part of medical examinations conducted by sports physicians for the purpose of obtaining an overall guiding picture of the subjects' health status.