Editor's Notes
A Cool Perspective on Heat Injury: Staying Vigilant in Varied Conditions
GORDON O. MATHESON, MD, PHD

News Briefs
Expert Panel Recommends Pertussis Booster • Sports Medicine Physicians Feel Katrina's Impact • CDC Launches Concussion Prevention Initiative • NFHS Issues Infectious Skin Disease Policy

Evaluation and Management of Hip Pain
The Emerging Role of Hip Arthroscopy
Managing hip pain in active people can be frustrating, not only because the differential diagnosis contains about 36 conditions, but also because patients may spend from months to years with no relief, despite intensive nonsurgical treatment. Hip arthroscopy is becoming a key tool for visualizing hip pathology and treating tears, lesions, impingement, loose bodies, and instability.
CHRISTOPHER M. LARSON, MD; JENNIFER SWARINGEN, MD; GRANT MORRISON, MD

Bilateral First Metatarsal Stress Fractures in a Field Hockey Player
First metatarsal stress fracture is rare. In this case, a physician who was evaluating a young female field hockey player for a recent onset of foot pain identified the injury in both of the patient's feet. When no evidence was seen on x-rays, the physician followed up with bone scan and magnetic resonance imaging. Treatment included rigid-soled shoes and relative rest for 4 to 6 weeks.
JOHN P. METZ, MD

Mind Over Matter
Deducing Heatstroke Pathology
Several unanswered questions about heatstroke should be explored within a different framework. Instead of assuming that normal physiology is overwhelmed by severe environmental demands, physicians and researchers should consider the possibility of a pathologic process, such as excess heat production in the muscles.
TIMOTHY D. NOAKES, MBCHB, MD, DSC

Common Threads in a Random Tapestry
Another Viewpoint on Exertional Heatstroke
Physicians are always on guard for heatstroke, because it can occur unpredictably in unlikely environmental conditions. Without reliable patterns and markers, developing a stronger sense of several factors—such as a lack of acclimatization—can tip an individual patient's scales toward greater heatstroke risk.
WILLIAM O. ROBERTS, MD

Pearls
A Coaching Focus on Concussions

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