The preparticipation physical examination: an update.

The evolution of the preparticipation physical examination (PPE) in the United States continues to advance. In May 2010, the fourth edition of the Preparticipation Physical Examination Evaluation (PPE-4) monograph was published. The monograph is a product reflecting the collaborative efforts of 6 author societies. This article provides a brief historical review of the PPE and then highlights the recent changes and updates contained in the PPE-4 monograph, including cardiovascular screening in athletes. New recommendations to include the PPE in all well-child care visits and the need to develop a nationwide standard for the PPE are discussed.