Clinical decision support that reasons like a sports physician: work up the acute knee for an ACL, apply the Ottawa rules to the sprain, run the concussion off the field and back by protocol, and load-manage the tendinopathy — with the decision rule and exactly what would change it. Built for verified physicians.
Two real sports-medicine questions, each reasoned the way HeyHippocrates answers: the skills fire, the answer is cited, the decision rule is explicit, and what's missing is flagged. Scroll to each.
A player who took a head hit, briefly dazed with headache and slowed reactions, now on the sideline — the decision?
Remove the athlete from play immediately — a suspected concussion is a clinical diagnosis and there is no same-day return. Use a sideline tool such as the SCAT to document symptoms, cognition and balance, and watch for red flags — a deteriorating level of consciousness, a focal deficit, repeated vomiting, a seizure or neck pain — which mandate emergency transfer and imaging. Recovery follows a graduated, stepwise return-to-sport protocol, advancing only while symptom-free, with medical clearance before full contact.
Decision ruleSuspected concussion → remove from play, no same-day return; SCAT sideline assessment; red flags (falling GCS, focal deficit, repeated vomiting, seizure, neck pain) → emergency imaging; graduated return-to-sport, symptom-free through stages, medical clearance before contact.
Not established from this alone — the symptom course, the red-flag exam and the history change the timeline and the workup.
A pivoting injury with an audible pop, immediate swelling and a sense of giving-way — the workup?
A pop with early swelling and instability points to an ACL rupture. Effusion within hours is a hemarthrosis and narrows the differential to ACL tear, fracture or patellar dislocation. Examine with the Lachman test — the most sensitive for the ACL — plus the pivot-shift and anterior drawer, and apply the Ottawa knee rules to decide on plain films; MRI defines the soft-tissue injury. Manage initially with the RICE principles and rehabilitation, then decide on reconstruction by activity demands and instability.
Decision rulePop + early hemarthrosis + instability → ACL rupture likely (also fracture, patellar dislocation); Lachman (most sensitive) + pivot-shift; Ottawa knee rules for x-ray; MRI for soft tissue; RICE + rehab, then reconstruction by demand and instability.
Not established from this alone — the exam, the imaging and the activity demands change the diagnosis and the treatment.
Illustrative simulations. The physician always decides.
The exact questions your field searches for — answered in the format the knowledge base speaks: the answer, the decision rule, what's missing, and the source.
Use the Ottawa ankle rules to decide on imaging: an x-ray is needed only with bony tenderness at the posterior edge or tip of either malleolus, tenderness at the navicular or the base of the fifth metatarsal, or an inability to bear weight for four steps both immediately and in the clinic. For the sprain itself, favor early functional treatment — protected weight-bearing, a brace, and progressive range, strength and proprioception work — over prolonged immobilization, which delays recovery.Ottawa ankle rules
Decision ruleOttawa ankle rules → x-ray only for malleolar/navicular/fifth-metatarsal-base tenderness or inability to bear weight 4 steps; otherwise functional treatment (brace, early weight-bearing, proprioceptive rehab) over immobilization.
Missing data: the exam findings, the weight-bearing and the mechanism change the need for imaging.
An audible pop, swelling within a few hours and a feeling of giving-way strongly suggest an anterior cruciate ligament rupture; a rapid hemarthrosis narrows it to ACL tear, intra-articular fracture or patellar dislocation. The Lachman test is the most sensitive physical sign, supported by the pivot-shift and anterior drawer, and MRI confirms the ligament and any associated meniscal or chondral injury. Treatment ranges from structured rehabilitation to reconstruction, decided by instability, activity level and associated injuries.AMSSM · knee
Decision rulePop + rapid effusion + instability → ACL rupture (vs fracture, patellar dislocation); Lachman most sensitive; MRI to confirm + associated injury; rehab vs reconstruction by instability, activity and associated damage.
Missing data: the physical exam, the MRI and the activity demands change the management.
Diagnose it clinically and remove the athlete the same day, with no return to play that day. Assess and monitor symptoms with a tool such as the SCAT, and escalate immediately for red-flag features. Return follows a graduated, stepwise protocol — light aerobic activity, sport-specific exercise, non-contact then full-contact training — advancing a step only if the athlete stays symptom-free, with medical clearance before full contact. Persistent symptoms warrant a multidisciplinary approach.Concussion in Sport
Decision ruleClinical diagnosis → same-day removal, no same-day return; SCAT monitoring; red flags → emergency care; graduated return-to-sport (aerobic → sport-specific → non-contact → contact), advance only symptom-free, medical clearance before contact.
Missing data: the symptom trajectory, the prior-concussion history and red flags change the timeline.
Treat tendinopathy — Achilles, patellar or lateral epicondyle — as a load problem, not simple inflammation. The core treatment is a progressive loading program, especially eccentric or heavy slow-resistance exercise, with relative rest and activity modification rather than complete rest. Avoid corticosteroid injection into or around a weight-bearing tendon, which weakens it and risks rupture. Reserve imaging and adjuncts for diagnostic doubt or the failure of a well-run rehabilitation program.AMSSM · tendinopathy
Decision ruleTendinopathy = load problem → progressive loading (eccentric or heavy slow-resistance) + activity modification, not rest; avoid corticosteroid injection into load-bearing tendons (rupture risk); imaging/adjuncts only for doubt or rehab failure.
Missing data: the tendon, the load history and the rehab response change the plan.
Your whole practice, one specialist brain — grounded in champion-authored, cited knowledge.
A generalist sports-medicine colleague across acute injury, concussion, overuse and tendinopathy, bone stress, the athlete screen and return-to-play — cited, non-directive, always with the decision rule.
Deep specialist agents for acute musculoskeletal injury, concussion and head injury, the endurance and overuse athlete, and return-to-play decision-making — each its own soul and knowledge base — plus your own uploaded materials.
From the sideline concussion call to the ACL exam the margin is thin. Only one of these reasons like a sports-medicine colleague whose every claim you can trace.
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It reasons in the frameworks you use — the Ottawa rules, the ACL exam, the concussion protocol and the tendinopathy loading model — and always shows the reasoning, the decision rule and what would change it. The decision always stays your call.
Both. Fellows use it to pressure-test a plan and learn the decision rule; attendings use it as a fast, cited second opinion on the sideline and in clinic. Access is gated to verified physicians.
Acute musculoskeletal injury, concussion and head injury, the endurance and overuse athlete, and return-to-play decision-making each have their own deep specialist agent on the Pro plan, on top of the full sports-medicine scope on Basic.
No. It is physician-facing clinical decision support — a cited thinking partner. It does not diagnose, does not treat, and gives no patient-facing advice. The decision always stays with you.
Every answer is grounded only in champion-authored, cited sports-medicine knowledge — traceable, not hallucinated — and always states the decision rule plus what data is missing, instead of a confident guess.
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