Normal imaging laterality on magnetic resonance imaging of the medial epicondyle of the elbow on the dominant side of adolescent male baseball players

Yoshizawa, Toyoko; Okamoto, Yoshikazu; Kenta, Tanaka; Makihara, Takeshi; Tonoe, Tomoko; Minami, Manabu; Yamazaki, Masashi

doi:10.1007/s00256-018-2921-9

Cited by 4 publications

(3 citation statements)

References 16 publications

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“…Similarly, other authors have assessed adaptive changes in the osseous structures of the elbow. Yoshizawa et al [13] demonstrated asymmetric enlargement of the medial epicondylar ossification center in the dominant compared to the nondominant elbow in 80 adolescent baseball players aged 9-14 years, suggesting that the UCL may induce excessive repetitive tensile stress on the medial epicondyle. Sada et al [14] showed an asymmetric increase in humerocapitellar volumetric bone mineral density and trabecular thickness in the dominant versus nondominant elbow of 17 baseball players aged 16-29 years, likely the result of repetitive valgus stresses generated by pitching.…”

Section: Discussionmentioning

confidence: 99%

“…The anterior bundle of the ulnar collateral ligament provides the main restraint against valgus stress at the elbow, making it particularly susceptible to injury in throwing athletes. A variety of anatomic adaptations can occur in response to repetitive valgus loading, including thickening of the ulnar collateral ligament (UCL) and osseous remodeling [9][10][11][12][13][14]. A spectrum of injuries can occur when these adaptive mechanisms fail as a consequence of compromised medial ligamentous integrity with resultant valgus instability resulting in accentuated loading of the radiocapitellar joint and excessive shear forces on the posteromedial elbow [6].…”

Section: Introductionmentioning

confidence: 99%

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Differences in Anatomic Adaptation and Injury Patterns Related to Valgus Extension Overload in Overhead Throwing Athletes

Stevens,

Chaudhari,

Kuhn

2024

Diagnostics

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The purpose of our study was to determine differences in adaptative and injury patterns in the elbow related to valgus extension overload (VEO) in overhead throwing athletes by age. A total of 86 overhead throwing athletes and 23 controls underwent MRI or MR arthrography (MRA) of the elbow. Throwing athletes were divided by age into three groups: ≤16 years (26 subjects), 17–19 years (25 subjects), and ≥20 years (35 subjects). Consensus interpretation of each MRI was performed, with measurements of ulnar collateral ligament (UCL) thickness and subchondral sclerosis at the radial head, humeral trochlea, and olecranon process. A higher frequency of apophyseal and stress injuries was seen in adolescent athletes and increased incidence of soft tissue injuries was observed in older athletes. Early adaptive and degenerative changes were observed with high frequency independent of age. Significant differences were observed between athletes and controls for UCL thickness (p < 0.001) and subchondral sclerosis at the radial head (p < 0.001), humeral trochlea (p < 0.001), and olecranon process (p < 0.001). Significant differences based on athlete age were observed for UCL thickness (p < 0.001) and subchondral sclerosis at the olecranon process (p = 0.002). Our study highlights differences in anatomic adaptations related to VEO at the elbow between overhead throwing athletes and control subjects, as well as across age in throwing athletes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Differences in Anatomic Adaptation and Injury Patterns Related to Valgus Extension Overload in Overhead Throwing Athletes

Stevens,

Chaudhari,

Kuhn

2024

Diagnostics

View full text Add to dashboard Cite

show abstract

“… 33 , 34 Changes to the medial epicondyle of the throwing side also have been identified from youth to adolescent baseball players through the use of ultrasonography, radiography, or MRI. 23 , 26 , 28 , 37 Therefore, it is possible that similar adaptive changes may exist in the elbows of throwing athletes caused by the effects of repetitive throwing on the ulnar sublime tubercle. As a result, our modified technique could be an efficient surgical option in patients who have a small medial epicondyle.…”

Section: Discussionmentioning

confidence: 99%

Ulnar Collateral Ligament Reconstruction With the Modified Jobe Technique in Baseball Pitchers

Yoshida

Takenaga

Takeuchi

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Tearing and insufficiency of the ulnar collateral ligament (UCL) of the elbow result in valgus instability, which can lead to pain while throwing and decline in performance in overhead athletes. Purpose: To assess the clinical results of a modified UCL reconstruction technique using 1 bone hole in the ulna and 1 bone tunnel in the humerus in baseball players. Study Design: Case series; Level of evidence, 4. Methods: The inclusion criteria were medial elbow pain preventing effective playing, clinically medial elbow laxity, and magnetic resonance imaging results consistent with UCL injury. Patients who were engaged in other sports and in other positions in baseball except pitchers were excluded from this study. Our modified Tommy John procedure was performed via a muscle-splitting approach and an original single-bone-tunnel technique, using a suture anchor. After a minimum of 24 months, patients were evaluated using the Conway scale and the Timmerman-Andrews score. Results: Of 31 patients, 20 baseball pitchers (20 male: 5 high school, 5 collegiate, 8 nonprofessional, and 2 professional pitchers) were reviewed. The mean patient age at the time of operation was 21.9 years, and the mean postoperative follow-up period was 35.1 months (range, 24-66 months). The mean Timmerman-Andrews subjective score improved significantly from pre- to postoperatively (from 68.3 to 98.3; P < .05); the objective score also improved significantly (from 81.1 to 96.4; P = .01). No complications were detected at the latest follow-up. Overall, 19 patients were able to return to their preinjury level of sports or higher. Conclusion: UCL reconstruction with 1 bone hole in the ulna and 1 bone tunnel in the humerus demonstrated satisfactory results in baseball pitchers. Our modified technique was safe and achieved satisfactory clinical results, with a 95% rate of return to sports.

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Change in MRI findings of medial collateral ligament injury in adolescent baseball players with no clinical symptoms over time

et al. 2019

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Normal imaging laterality on magnetic resonance imaging of the medial epicondyle of the elbow on the dominant side of adolescent male baseball players

Cited by 4 publications

References 16 publications

Differences in Anatomic Adaptation and Injury Patterns Related to Valgus Extension Overload in Overhead Throwing Athletes

Differences in Anatomic Adaptation and Injury Patterns Related to Valgus Extension Overload in Overhead Throwing Athletes

Ulnar Collateral Ligament Reconstruction With the Modified Jobe Technique in Baseball Pitchers

Change in MRI findings of medial collateral ligament injury in adolescent baseball players with no clinical symptoms over time

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