Preexisting musculoskeletal conditions presenting as school sports injuries

One hundred thousand insurance claims for secondary school injuries sustained between 1974 and 1986 were analyzed to determine the incidence of diagnosis and misdiagnosis of preexisting musculoskeletal conditions. Seventy-five percent of accident reports described acute injury to normal bones, joints, and soft tissues. Twenty percent were reinjuries or other sequelae of past trauma. Infection, congenital or developmental anomalies, or other nontraumatic conditions were found in 5% of the injuries reported. Patients with preexisting diseases had a higher morbidity than those with an acute primary injury. The majority of preexisting conditions were correctly described and documented by the attending physician. However, for 268 patients with a previous accident residual and 465 patients suffering from infection, pathologic fracture, congenital/developmental disorder, neoplasia, or other diseases, the potential role of the underlying condition was not correctly stated. Correct preexisting diagnoses need to be recognized if treatment is to be optimal.