Chronically stressed wrists in adolescent gymnasts: MR imaging appearance.

Shih, Chunhsi; Chang, Cheng-Yen; Penn, I-Wen; Tiu, Chiu-Mei; Chang, Tsuen; Wu, Jiunn-Jer

doi:10.1148/radiology.195.3.7754021

Cited by 102 publications

(36 citation statements)

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“…MRI revealed bone marrow edemalike signal in the medial clavicle extending from the physis into the metadiaphysis, reflecting an osseous stress reaction. These changes are similar to the ricketslike changes described as a ''gymnast wrist'' [12,19]. This study was interpreted by our musculoskeletal radiologist as being consistent with a stress lesion of the proximal left and right clavicular physes.…”

Section: Case Reportsupporting

confidence: 79%

Case Report: Bilateral Proximal Epiphyseal Clavicular Stress-related Lesions in a Male Gymnast

Carson

McCambridge

Carrino

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Stress lesions of the upper extremity are relatively uncommon, and physeal stress lesions of the clavicle are rare. We present a case of bilateral physeal stress-related lesions of the proximal clavicular growth plate near the sternoclavicular joint in an adolescent male gymnast. Case Description A 13-year-old gymnast presented with a 3-week history of insidious onset of pain in the proximal clavicular area of his left shoulder. He had no pain at rest or at night. He recently had added a new maneuver to his routine. His radiographs were normal, but further study with CT scanning confirmed a stress lesion of his proximal clavicular physis. The lesion healed with time, and he returned to gymnastics with no symptoms. Approximately 5 months after the initial symptoms on the left side, he felt a pop and immediate pain in his right sternoclavicular joint area while doing a routine. Imaging revealed a chronic stress lesion of the proximal physis similar to that of the other side. The patient achieved healing with rest and returned to gymnastics with no limitations. Literature Review Physeal stress-related lesions of the proximal clavicular physis have not been reported in the literature. Purpose and Clinical Relevance Medial clavicle pain in adolescent gymnasts may be secondary to stress-related lesions of the proximal clavicular growth plate. Such lesions are rare.

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Section: Case Reportsupporting

confidence: 79%

Case Report: Bilateral Proximal Epiphyseal Clavicular Stress-related Lesions in a Male Gymnast

Carson

McCambridge

Carrino

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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“…The words bone bruise, bone contusion, occult fracture and occult osseous lesion have been used synonymously for areas in cancellous bone, showing low signal intensity on T1-weighted and high signal intensity on T2-weighted MRI (Mink and Deutsch 1989, Deutsch et al 1990, Kier et al 1991, Stallenberg et al 1993, Escalas and Curell 1994, Laorr et al 1995, Shih et al 1995, Stein et al 1995, Zeiss et al 1995. It has been suggested that they represent a spectrum of radiographically occult bone injuries, ranging from bleeding, infarction and edema to microscopic compression fractures of cancellous bone (Kier et al 1991, Zeiss et al 1995.…”

Section: Discussionmentioning

confidence: 99%

“…The articular cartilage was normal. Since then, bone bruise injuries have been reported frequently in the knee (Mink and Deutsch 1989, Vellet et al 1991, Murphy et al 1992, Stallenberg et al 1993, Stein et al 1995, Zeiss et al 1995, Rangger et al 1996 and also in the wrist, the calcaneus, the foot and ankle, and in the hip (Kier et al 1991, Laorr et al 1995, Shih et al 1995, Soudry and Mannting 1995.…”

Section: Bone Bruise Of the Knee Histology And Cryosections In 5 Casesmentioning

confidence: 99%

Bone bruise of the knee Histology and cryosections in 5 cases

Rangger

Kathrein

Freund

et al. 1998

Acta Orthopaedica Scandinavica

186

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“…Radiographs can show the ulnar plus deformation as well as widening and irregularity of the physis, narrowing of the epiphysis and sclerosis or cystic changes in the metaphysis [19]. If inconclusive, MRI can depict physeal cartilage extension into the metaphysis, bone bruise or vertical fractures [20].…”

Section: Wrist/handmentioning

confidence: 99%

Sport injuries in the paediatric and adolescent patient: a growing problem

et al. 2009

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With an increasing number of paediatric and adolescent athletes presenting with injuries due to overuse, a greater demand is put on clinicians and radiologists to assess the specific type of injury. Repetitive forces applied to the immature skeleton cause a different type of injury than those seen in adults due to the differences in vulnerability of the musculoskeletal system, especially at the site of the growth cartilage. Intrinsic and extrinsic risk factors all play a role in the development of overuse injuries. MRI plays a key role in imaging overuse injuries due to its high potential for depicting cartilaginous and softtissue structures. Sport-specific biomechanics are described, since this knowledge is essential for adequate MRI assessment. An overview of several sport-related injuries is presented, based on anatomical location.

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Chronically stressed wrists in adolescent gymnasts: MR imaging appearance.

Abstract: Physeal cartilage extension into the metaphysis represents a healing sign in chronically stressed adolescent wrists. MR imaging findings including horizontal fracture and physeal cartilage extension to the metaphysis suggest that physeal widening occurred secondary to metaphyseal injury.

Cited by 102 publications

References 0 publications

Case Report: Bilateral Proximal Epiphyseal Clavicular Stress-related Lesions in a Male Gymnast

Case Report: Bilateral Proximal Epiphyseal Clavicular Stress-related Lesions in a Male Gymnast

Bone bruise of the knee Histology and cryosections in 5 cases

Sport injuries in the paediatric and adolescent patient: a growing problem

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