What does it actually take to diagnose REDs, and what happens after?

If you've ever wondered what's going on behind the scenes when a sports medicine physician suspects REDs, this episode is your inside look. Host Heather Caplan, RDN, sits down with Dr. Rosa Pasculli, a non-operative sports medicine physician based in Atlanta, to walk through the full medical picture: how REDs gets diagnosed, what labs actually matter and why, and what treatment looks like in practice. It's a masterclass in multidisciplinary care, and a reminder of just how important it is to have a physician on your team who knows how to ask the right questions.

Dr. Pasculli is a former competitive dancer turned sports medicine physician with a particular clinical interest in bone stress injuries and REDs. She is the head team physician for Emory University, overseeing 450+ varsity athletes, and serves as a consulting physician for the Atlanta Ballet, the Georgia Ballet, and the Atlanta Falcons Cheerleaders. She also sees runners, weekend warriors, and masters athletes, including, as she mentions in this episode, an 80-year-old woman doing an Ironman.

07:59- How Rosa got into sports medicine and the female athlete space 12:44- What she's seeing in the clinic: awareness of REDs and where education still falls short 14:47- REDs as a diagnosis of exclusion: what that means and why it takes a team 15:51- Lab work 101: CBC, CMP, ferritin, thyroid, and what Rosa is actually looking for 21:48- DEXA scans: who needs one and when, including the Female Athlete Triad Coalition's updated guidelines 24:22- Medical management of REDs: risk stratification, the REDs CAT2 tool, and keeping athletes in sport where possible 25:26- When it becomes dangerous: bradycardia, orthostatic changes, and the malnourished heart 28:34- Setting expectations with patients and parents around timeline and testing frequency 30:31- The Emory Women's Sports Medicine program and the cross-institutional community behind it

Resources mentioned:

• IOC RED-S CAT2 Tool (2023)- free Excel-based risk stratification tool for clinicians

• Female Athlete Triad Coalition- updated DEXA scan guidelines for adolescent and adult athletes

• Emory Women's Sport and Wellness Conference- Saturday, August 15th, in-person and virtual; registration opening soon

• Connect with Dr. Pasculli through the Lane 9 Directory at lane9project.org/directory

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