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Emergency Medicine2208 papers

Soft tissue infection

Last edited: 4/13/2026

Overview

Soft tissue infections encompass a range of conditions from superficial cellulitis to deeper abscesses and necrotizing fasciitis, often caused by bacterial pathogens including community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA). 1222

Diagnosis

  • Clinical Presentation: Redness, swelling, pain, warmth, and systemic symptoms like fever. 222
  • Physical Examination: Essential for assessing severity and guiding management. 36
  • Imaging: Point-of-care ultrasound (POCUS) useful for differentiating cellulitis from abscess and guiding drainage. 126
  • Laboratory Tests: Blood cultures, white blood cell count, and inflammatory markers (CRP, ESR) to assess severity and guide antibiotic therapy. 222
  • Grading Systems: AAST EGS grading system for severity assessment in emergency general surgery settings. 13
  • Management

  • Antibiotics: Initial broad-spectrum coverage, tailored based on culture and sensitivity results. For severe infections, consider agents like vancomycin or linezolid for MRSA coverage. 222
  • Incision and Drainage (I&D): Essential for abscesses to prevent complications. Procedural sedation may be required, especially in pediatric patients. 1724
  • Supportive Care: Pain management, hydration, and monitoring for systemic complications. 50
  • Adjunctive Therapies: Hyaluronidase for filler-induced complications, heat, and massage for certain vascular issues. 1
  • Advanced Wound Care: Hydrogels and flaps for complex soft tissue defects. 516
  • Special Populations

  • Pediatrics: POCUS can decrease length of stay and guide appropriate antibiotic therapy. Procedural sedation is often necessary for I&D. 1224
  • Elderly and Comorbidities: Increased risk of complications; careful monitoring and tailored antibiotic therapy based on comorbidities. 15
  • Pregnancy: Management focuses on safe antibiotic choices and avoiding teratogenic agents; close monitoring of maternal and fetal well-being. [No specific abstract covers this directly]
  • Key Recommendations

  • Use POCUS for pediatric patients to differentiate cellulitis from abscess and guide management, potentially reducing hospital stay. (Evidence: Moderate) 12
  • Initiate broad-spectrum antibiotics tailored to local resistance patterns and adjust based on culture results, especially considering MRSA prevalence. (Evidence: Strong) 222
  • Perform incision and drainage for abscesses to prevent complications; consider procedural sedation in pediatric cases. (Evidence: Moderate) 1724
  • Utilize validated grading systems like AAST EGS for severity assessment in emergency settings. (Evidence: Moderate) 13
  • Consider advanced wound healing techniques such as hydrogels and flaps for complex soft tissue defects. (Evidence: Weak) 516
  • References

    1 Bazzi M, Dekany V, Zou H, Deirawan H, Daveluy S. Structured Training of Dermatology Residents in the Management of Soft-Tissue Filler-Induced Vascular Complications. Journal of drugs in dermatology : JDD 2025. link 2 Ohnishi T, Watanabe S, Matsumoto T, Yotsuyanagi H, Sato J, Kobayashi I et al.. The second nationwide surveillance of antibacterial susceptibility patterns of pathogens isolated from skin and soft-tissue infections in dermatology departments in Japan. Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 2023. link 3 Xue Y, Riva N, Zhao L, Shieh JS, Chin YT, Gatt A et al.. Recent advances of exosomes in soft tissue injuries in sports medicine: A critical review on biological and biomaterial applications. Journal of controlled release : official journal of the Controlled Release Society 2023. link 4 Mistry RD, Hogan PG, Parrish KL, Thompson RM, Fritz SA. Skin and Soft Tissue Infection Treatment and Prevention Practices by Pediatric Emergency Medicine Providers. Pediatric emergency care 2022. link 5 Kurowiak J, Kaczmarek-Pawelska A, Mackiewicz A, Baldy-Chudzik K, Mazurek-Popczyk J, Zaręba Ł et al.. Changes in the Mechanical Properties of Alginate-Gelatin Hydrogels with the Addition of . International journal of molecular sciences 2022. link 6 Lam SHF, Alade K, Brennan J, Castillo EM, Doniger SJ, Levine MC et al.. Interpretation Accuracy and Interrater Agreement of Pediatric Skin and Soft Tissue Point-of-Care Ultrasound Images among Residents and Faculty. The Journal of emergency medicine 2020. link 7 Herrmann M, Babler A, Moshkova I, Gremse F, Kiessling F, Kusebauch U et al.. Lumenal calcification and microvasculopathy in fetuin-A-deficient mice lead to multiple organ morbidity. PloS one 2020. link 8 Follette CM, Giuffrida MA, Balsa IM, Culp WTN, Mayhew PD, Oblak ML et al.. A systematic review of criteria used to report complications in soft tissue and oncologic surgical clinical research studies in dogs and cats. Veterinary surgery : VS 2020. link 9 Evenski AJ, Stensby JD, Rosas S, Emory CL. Diagnostic Imaging and Management of Common Intra-articular and Peri-articular Soft Tissue Tumors and Tumorlike Conditions of the Knee. The journal of knee surgery 2019. link 10 Sadan N, Sabag P, Cohen K, Bisharat N. The utility of adding symptoms and signs to the management of injury-related pain. Injury 2019. link 11 Nicholas MK, Costa DSJ, Linton SJ, Main CJ, Shaw WS, Pearce R et al.. Predicting Return to Work in a Heterogeneous Sample of Recently Injured Workers Using the Brief ÖMPSQ-SF. Journal of occupational rehabilitation 2019. link 12 Lin MJ, Neuman M, Rempell R, Monuteaux M, Levy J. Point-of-Care Ultrasound is Associated With Decreased Length of Stay in Children Presenting to the Emergency Department With Soft Tissue Infection. The Journal of emergency medicine 2018. link 13 Ray-Zack MD, Hernandez MC, Younis M, Hoch WB, Soukup DS, Haddad NN et al.. Validation of the American Association for the Surgery of Trauma emergency general surgery grade for skin and soft tissue infection. The journal of trauma and acute care surgery 2018. link 14 Hamid MSA. Cost Effectiveness of a Platelet-rich Plasma Preparation Technique for Clinical Use. Wounds : a compendium of clinical research and practice 2018. link 15 Yoshizawa T, Ishikawa K, Nagasawa H, Takeuchi I, Jitsuiki K, Omori K et al.. A Fatal Case of Super-super Obesity (BMI >80) in a Patient with a Necrotic Soft Tissue Infection. Internal medicine (Tokyo, Japan) 2018. link 16 Li-You W, Hong-Wei Z, Gang Z, Guo-Qiang W, Fan Y. Treatment of soft tissue defects in the heels of children in an emergency setting. Journal of pediatric orthopedics. Part B 2017. link 17 Yadav K, Gatien M, Corrales-Medina V, Stiell I. Antimicrobial treatment decision for non-purulent skin and soft tissue infections in the emergency department. CJEM 2017. link 18 Watanabe S, Ohnishi T, Yuasa A, Kiyota H, Iwata S, Kaku M et al.. The first nationwide surveillance of antibacterial susceptibility patterns of pathogens isolated from skin and soft-tissue infections in dermatology departments in Japan. Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 2017. link 19 Pincus D, Kuhn JE, Sheth U, Rizzone K, Colbenson K, Dwyer T et al.. A Systematic Review and Appraisal of Clinical Practice Guidelines for Musculoskeletal Soft Tissue Injuries and Conditions. The American journal of sports medicine 2017. link 20 Fomenko O, Gruber J. Claims-shifting: The problem of parallel reimbursement regimes. Journal of health economics 2017. link 21 Stevens DL, Bisno AL, Chambers HF, Dellinger EP, Goldstein EJ, Gorbach SL et al.. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2014. link 22 Stevens DL, Bisno AL, Chambers HF, Dellinger EP, Goldstein EJ, Gorbach SL et al.. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the infectious diseases society of America. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2014. link 23 Ostojic SM, Vukomanovic B, Calleja-Gonzalez J, Hoffman JR. Effectiveness of oral and topical hydrogen for sports-related soft tissue injuries. Postgraduate medicine 2014. link 24 Uspal NG, Marin JR, Alpern ER, Zorc JJ. Factors associated with the use of procedural sedation during incision and drainage procedures at a children's hospital. The American journal of emergency medicine 2013. link 25 Zhao J, Wang P, Jiang B. Using the pedicle flap for taking pressure off the pedicle in distally based skin flaps. Journal of reconstructive microsurgery 2013. link 26 Fritz SA, Long M, Gaebelein CJ, Martin MS, Hogan PG, Yetter J. Practices and procedures to prevent the transmission of skin and soft tissue infections in high school athletes. The Journal of school nursing : the official publication of the National Association of School Nurses 2012. link 27 Marin JR, Alpern ER, Panebianco NL, Dean AJ. Assessment of a training curriculum for emergency ultrasound for pediatric soft tissue infections. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 2011. link 28 Jabbour N, Dobratz EJ, Dresner HS, Hilger PA. Assessing fundamental 2-dimensional understanding of basic soft tissue techniques. Journal of surgical education 2011. link 29 LoVecchio F, Perera N, Casanova L, Mulrow M, Pohl A. Board-certified emergency physicians' treatment of skin and soft tissue infections in the community-acquired methicillin-resistant Staphylococcus aureus era. The American journal of emergency medicine 2009. link 30 Obert L, Lepage D, Gindraux F, Garbuio P. Bone morphogenetic proteins in soft-tissue reconstruction. Injury 2009. link70006-3) 31 Ramirez-Schrempp D, Dorfman DH, Baker WE, Liteplo AS. Ultrasound soft-tissue applications in the pediatric emergency department: to drain or not to drain?. Pediatric emergency care 2009. link 32 Abrahamian FM, Talan DA, Moran GJ. Management of skin and soft-tissue infections in the emergency department. Infectious disease clinics of North America 2008. link 33 Sloan J. Soft tissue injuries: introduction and basic principles. Emergency medicine journal : EMJ 2008. link 34 Rittner AV, Fitzpatrick K, Corfield A. Best evidence topic report. Are antibiotics indicated following human bites?. Emergency medicine journal : EMJ 2005. link 35 Paoloni JA, Orchard JW. The use of therapeutic medications for soft-tissue injuries in sports medicine. The Medical journal of Australia 2005. link 36 Zalar GL. The dermatologist's role in managing skin and soft tissue infections. Cutis 2004. link 37 Ozkan O, Coşkunfirat OK, Ozgentaş HE. An ideal and versatile material for soft-tissue coverage: experiences with most modifications of the anterolateral thigh flap. Journal of reconstructive microsurgery 2004. link 38 MacAuley D. Do textbooks agree on their advice on ice?. Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine 2001. link 39 Eskey CJ, Robson CD, Weber AL. Imaging of benign and malignant soft tissue tumors of the neck. Radiologic clinics of North America 2000. link70223-2) 40 Lin SD, Chou CK, Lin TM, Wang HJ, Lai CS. The distally based lateral adipofascial flap. British journal of plastic surgery 1998. link 41 Erlandson RA, Woodruff JM. Role of electron microscopy in the evaluation of soft tissue neoplasms, with emphasis on spindle cell and pleomorphic tumors. Human pathology 1998. link90005-3) 42 Howell JM, Chisholm CD. Wound care. Emergency medicine clinics of North America 1997. link70308-4) 43 Hettinger DF. Soft tissue surgery using radiowave techniques. Journal of the American Podiatric Medical Association 1997. link 44 Evans RC, Jones NL. The management of abrasions and bruises. Journal of wound care 1996. link 45 Hsu SS, Hallagan LF. Case report of a coyote attack in Yellowstone National Park. Wilderness & environmental medicine 1996. link007[0170:croaca]2.3.co;2) 46 Gerich TG, Fu FH, Robbins PD, Evans CH. Prospects for gene therapy in sports medicine. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 1996. link 47 Swenson C, Swärd L, Karlsson J. Cryotherapy in sports medicine. Scandinavian journal of medicine & science in sports 1996. link 48 Hart LE. Exercise and soft tissue injury. Bailliere's clinical rheumatology 1994. link80228-6) 49 Adebajo AO, Hazleman BL. Soft tissue shoulder lesions in the African. British journal of rheumatology 1992. link 50 Berman D, Graber D. Sedation and analgesia. Emergency medicine clinics of North America 1992. link 51 Hohl M. Soft tissue neck injuries--a review. Revue de chirurgie orthopedique et reparatrice de l'appareil moteur 1990. link 52 Bollen SR. Upper limb injuries in elite rock climbers. Journal of the Royal College of Surgeons of Edinburgh 1990. link 53 Welford R. Injuries in children's sport. The Practitioner 1989. link 54 Travers PH. Soft tissue disorders of the upper extremities. Occupational medicine (Philadelphia, Pa.) 1988. link 55 Black AS, Kanat IO. A review of soft tissue calcifications. The Journal of foot surgery 1985. link 56 Meier JL, Gerster JC. Bursitis and tenosynovitis caused by group G streptococci. The Journal of rheumatology 1983. link 57 Klein AW. Implantation technics for injectable collagen. Two and one-half years of personal clinical experience. Journal of the American Academy of Dermatology 1983. link70133-7) 58 Kaplan EN, Falces E, Tolleth H. Clinical utilization of injectable collagen. Annals of plastic surgery 1983. link 59 Alexander MJ, Haddow JB. A kinematic analysis of an upper extremity ballistic skill: the windmill pitch. Canadian journal of applied sport sciences. Journal canadien des sciences appliquees au sport 1982. link 60 Muckle DS. A double-blind trial of flurbiprofen and aspirin in soft-tissue trauma. Rheumatology and rehabilitation 1977. link

    Original source

    1. [1]
      Structured Training of Dermatology Residents in the Management of Soft-Tissue Filler-Induced Vascular Complications.Bazzi M, Dekany V, Zou H, Deirawan H, Daveluy S Journal of drugs in dermatology : JDD (2025)
    2. [2]
      The second nationwide surveillance of antibacterial susceptibility patterns of pathogens isolated from skin and soft-tissue infections in dermatology departments in Japan.Ohnishi T, Watanabe S, Matsumoto T, Yotsuyanagi H, Sato J, Kobayashi I et al. Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy (2023)
    3. [3]
      Recent advances of exosomes in soft tissue injuries in sports medicine: A critical review on biological and biomaterial applications.Xue Y, Riva N, Zhao L, Shieh JS, Chin YT, Gatt A et al. Journal of controlled release : official journal of the Controlled Release Society (2023)
    4. [4]
      Skin and Soft Tissue Infection Treatment and Prevention Practices by Pediatric Emergency Medicine Providers.Mistry RD, Hogan PG, Parrish KL, Thompson RM, Fritz SA Pediatric emergency care (2022)
    5. [5]
      Changes in the Mechanical Properties of Alginate-Gelatin Hydrogels with the Addition of Kurowiak J, Kaczmarek-Pawelska A, Mackiewicz A, Baldy-Chudzik K, Mazurek-Popczyk J, Zaręba Ł et al. International journal of molecular sciences (2022)
    6. [6]
      Interpretation Accuracy and Interrater Agreement of Pediatric Skin and Soft Tissue Point-of-Care Ultrasound Images among Residents and Faculty.Lam SHF, Alade K, Brennan J, Castillo EM, Doniger SJ, Levine MC et al. The Journal of emergency medicine (2020)
    7. [7]
      Lumenal calcification and microvasculopathy in fetuin-A-deficient mice lead to multiple organ morbidity.Herrmann M, Babler A, Moshkova I, Gremse F, Kiessling F, Kusebauch U et al. PloS one (2020)
    8. [8]
      A systematic review of criteria used to report complications in soft tissue and oncologic surgical clinical research studies in dogs and cats.Follette CM, Giuffrida MA, Balsa IM, Culp WTN, Mayhew PD, Oblak ML et al. Veterinary surgery : VS (2020)
    9. [9]
    10. [10]
      The utility of adding symptoms and signs to the management of injury-related pain.Sadan N, Sabag P, Cohen K, Bisharat N Injury (2019)
    11. [11]
      Predicting Return to Work in a Heterogeneous Sample of Recently Injured Workers Using the Brief ÖMPSQ-SF.Nicholas MK, Costa DSJ, Linton SJ, Main CJ, Shaw WS, Pearce R et al. Journal of occupational rehabilitation (2019)
    12. [12]
    13. [13]
      Validation of the American Association for the Surgery of Trauma emergency general surgery grade for skin and soft tissue infection.Ray-Zack MD, Hernandez MC, Younis M, Hoch WB, Soukup DS, Haddad NN et al. The journal of trauma and acute care surgery (2018)
    14. [14]
      Cost Effectiveness of a Platelet-rich Plasma Preparation Technique for Clinical Use.Hamid MSA Wounds : a compendium of clinical research and practice (2018)
    15. [15]
      A Fatal Case of Super-super Obesity (BMI >80) in a Patient with a Necrotic Soft Tissue Infection.Yoshizawa T, Ishikawa K, Nagasawa H, Takeuchi I, Jitsuiki K, Omori K et al. Internal medicine (Tokyo, Japan) (2018)
    16. [16]
      Treatment of soft tissue defects in the heels of children in an emergency setting.Li-You W, Hong-Wei Z, Gang Z, Guo-Qiang W, Fan Y Journal of pediatric orthopedics. Part B (2017)
    17. [17]
    18. [18]
      The first nationwide surveillance of antibacterial susceptibility patterns of pathogens isolated from skin and soft-tissue infections in dermatology departments in Japan.Watanabe S, Ohnishi T, Yuasa A, Kiyota H, Iwata S, Kaku M et al. Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy (2017)
    19. [19]
      A Systematic Review and Appraisal of Clinical Practice Guidelines for Musculoskeletal Soft Tissue Injuries and Conditions.Pincus D, Kuhn JE, Sheth U, Rizzone K, Colbenson K, Dwyer T et al. The American journal of sports medicine (2017)
    20. [20]
      Claims-shifting: The problem of parallel reimbursement regimes.Fomenko O, Gruber J Journal of health economics (2017)
    21. [21]
      Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America.Stevens DL, Bisno AL, Chambers HF, Dellinger EP, Goldstein EJ, Gorbach SL et al. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (2014)
    22. [22]
      Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the infectious diseases society of America.Stevens DL, Bisno AL, Chambers HF, Dellinger EP, Goldstein EJ, Gorbach SL et al. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (2014)
    23. [23]
      Effectiveness of oral and topical hydrogen for sports-related soft tissue injuries.Ostojic SM, Vukomanovic B, Calleja-Gonzalez J, Hoffman JR Postgraduate medicine (2014)
    24. [24]
      Factors associated with the use of procedural sedation during incision and drainage procedures at a children's hospital.Uspal NG, Marin JR, Alpern ER, Zorc JJ The American journal of emergency medicine (2013)
    25. [25]
      Using the pedicle flap for taking pressure off the pedicle in distally based skin flaps.Zhao J, Wang P, Jiang B Journal of reconstructive microsurgery (2013)
    26. [26]
      Practices and procedures to prevent the transmission of skin and soft tissue infections in high school athletes.Fritz SA, Long M, Gaebelein CJ, Martin MS, Hogan PG, Yetter J The Journal of school nursing : the official publication of the National Association of School Nurses (2012)
    27. [27]
      Assessment of a training curriculum for emergency ultrasound for pediatric soft tissue infections.Marin JR, Alpern ER, Panebianco NL, Dean AJ Academic emergency medicine : official journal of the Society for Academic Emergency Medicine (2011)
    28. [28]
      Assessing fundamental 2-dimensional understanding of basic soft tissue techniques.Jabbour N, Dobratz EJ, Dresner HS, Hilger PA Journal of surgical education (2011)
    29. [29]
      Board-certified emergency physicians' treatment of skin and soft tissue infections in the community-acquired methicillin-resistant Staphylococcus aureus era.LoVecchio F, Perera N, Casanova L, Mulrow M, Pohl A The American journal of emergency medicine (2009)
    30. [30]
      Bone morphogenetic proteins in soft-tissue reconstruction.Obert L, Lepage D, Gindraux F, Garbuio P Injury (2009)
    31. [31]
      Ultrasound soft-tissue applications in the pediatric emergency department: to drain or not to drain?Ramirez-Schrempp D, Dorfman DH, Baker WE, Liteplo AS Pediatric emergency care (2009)
    32. [32]
      Management of skin and soft-tissue infections in the emergency department.Abrahamian FM, Talan DA, Moran GJ Infectious disease clinics of North America (2008)
    33. [33]
      Soft tissue injuries: introduction and basic principles.Sloan J Emergency medicine journal : EMJ (2008)
    34. [34]
      Best evidence topic report. Are antibiotics indicated following human bites?Rittner AV, Fitzpatrick K, Corfield A Emergency medicine journal : EMJ (2005)
    35. [35]
      The use of therapeutic medications for soft-tissue injuries in sports medicine.Paoloni JA, Orchard JW The Medical journal of Australia (2005)
    36. [36]
    37. [37]
      An ideal and versatile material for soft-tissue coverage: experiences with most modifications of the anterolateral thigh flap.Ozkan O, Coşkunfirat OK, Ozgentaş HE Journal of reconstructive microsurgery (2004)
    38. [38]
      Do textbooks agree on their advice on ice?MacAuley D Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine (2001)
    39. [39]
      Imaging of benign and malignant soft tissue tumors of the neck.Eskey CJ, Robson CD, Weber AL Radiologic clinics of North America (2000)
    40. [40]
      The distally based lateral adipofascial flap.Lin SD, Chou CK, Lin TM, Wang HJ, Lai CS British journal of plastic surgery (1998)
    41. [41]
    42. [42]
      Wound care.Howell JM, Chisholm CD Emergency medicine clinics of North America (1997)
    43. [43]
      Soft tissue surgery using radiowave techniques.Hettinger DF Journal of the American Podiatric Medical Association (1997)
    44. [44]
      The management of abrasions and bruises.Evans RC, Jones NL Journal of wound care (1996)
    45. [45]
      Case report of a coyote attack in Yellowstone National Park.Hsu SS, Hallagan LF Wilderness & environmental medicine (1996)
    46. [46]
      Prospects for gene therapy in sports medicine.Gerich TG, Fu FH, Robbins PD, Evans CH Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA (1996)
    47. [47]
      Cryotherapy in sports medicine.Swenson C, Swärd L, Karlsson J Scandinavian journal of medicine & science in sports (1996)
    48. [48]
      Exercise and soft tissue injury.Hart LE Bailliere's clinical rheumatology (1994)
    49. [49]
      Soft tissue shoulder lesions in the African.Adebajo AO, Hazleman BL British journal of rheumatology (1992)
    50. [50]
      Sedation and analgesia.Berman D, Graber D Emergency medicine clinics of North America (1992)
    51. [51]
      Soft tissue neck injuries--a review.Hohl M Revue de chirurgie orthopedique et reparatrice de l'appareil moteur (1990)
    52. [52]
      Upper limb injuries in elite rock climbers.Bollen SR Journal of the Royal College of Surgeons of Edinburgh (1990)
    53. [53]
      Injuries in children's sport.Welford R The Practitioner (1989)
    54. [54]
      Soft tissue disorders of the upper extremities.Travers PH Occupational medicine (Philadelphia, Pa.) (1988)
    55. [55]
      A review of soft tissue calcifications.Black AS, Kanat IO The Journal of foot surgery (1985)
    56. [56]
      Bursitis and tenosynovitis caused by group G streptococci.Meier JL, Gerster JC The Journal of rheumatology (1983)
    57. [57]
    58. [58]
      Clinical utilization of injectable collagen.Kaplan EN, Falces E, Tolleth H Annals of plastic surgery (1983)
    59. [59]
      A kinematic analysis of an upper extremity ballistic skill: the windmill pitch.Alexander MJ, Haddow JB Canadian journal of applied sport sciences. Journal canadien des sciences appliquees au sport (1982)
    60. [60]
      A double-blind trial of flurbiprofen and aspirin in soft-tissue trauma.Muckle DS Rheumatology and rehabilitation (1977)

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