Board of Certification for the Athletic Trainer (BOC) Practice Test

Which condition should be ruled out when a hockey player shows no signs of atrophy or ecchymosis?

1. Acute muscle tear

2. Chronic bursitis

3. Ligament sprain

4. Stress fracture

The correct answer is: Stress fracture

Ruling out a stress fracture when a hockey player shows no signs of atrophy or ecchymosis is important because stress fractures typically develop over time due to repetitive stress rather than acute trauma, and they are often associated with gradual onset of pain. Unlike other acute injuries, stress fractures might not present with visible signs such as swelling or bruising (ecchymosis) and usually won't cause muscle atrophy unless the condition is chronic and severe, leading to disuse of the affected area. In contrast, acute muscle tears generally come with significant swelling and possible discoloration, while ligament sprains often present with swelling, bruising, and a decrease in joint stability. Chronic bursitis may lead to localized swelling but typically does not cause the same immediate and acute signs as other injuries. Therefore, the absence of atrophy or ecchymosis makes a stress fracture less likely, prompting the need to investigate other potential injuries that would present with such symptoms.