Avoid ordering an abdominal ultrasound examination routinely in athletes with infectious mononucleosis.
Splenic enlargement is common in patients with infectious mononucleosis. The spleen is at increased risk for splenic rupture in the first 3–4 weeks of infection. This has led many clinicians to utilize ultrasound to determine if splenic enlargement is present. However, because individual splenic diameters vary greatly, comparing splenic size to population norms is not a valid method to assess splenic enlargement.
These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.
The American Medical Society for Sports Medicine (AMSSM) has identified this list of clinical recommendations for the Choosing Wisely® campaign. The goal was to identify common topics in the practice of sports medicine that, supported by a review of the literature, would lead to significant health benefits and a reduction of common procedures that can be unnecessary or cause harm. For each item, evidence was reviewed from peer-reviewed literature and several sports medicine consensus statements. The list was initially generated and drafted by AMSSM’s Quality Measures Subcommittee. It was then edited and approved by AMSSM’s Practice and Policy Committee and the Board of Directors.
The American Medical Society for Sports Medicine’s disclosure and conflict of interest policy can be found at www.amssm.org.
Putukian M, O’Connor FG, Stricker P, McGrew C, Hosey RG, Gordon SM, Kinderknecht J, Kriss V, Landry G. Mononucleosis and athletic participation: an evidence-based subject review. Clin J Sport Med. 2008 Jul;18(4):309–15.
Spielmann AL, DeLong DM, Kliewer MA. Sonographic evaluation of spleen size in tall healthy athletes. Am J Roentgenol. 2005 Jan;184(1):45–9.
Hosey RG, Mattacola CG, Kriss V, Armsey T, Quarles JD, Jagger J. Ultrasound assessment of spleen size in collegiate athletes. Br J Sports Med. 2006 Mar;40(3):251–4.