Upper extremity ischemia in athletes: Embolism from the injured posterior circumflex humeral artery

Ikezawa, Teruo; Iwatsuka, Yasushi; Asano, Masayuki; Kimura, Atsushi; Sasamoto, Akitoshi; Ono, Yoshio

doi:10.1007/bf01616493

Cited by 11 publications

(3 citation statements)

References 5 publications

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“…We found 19 cases of volleyball-related PCHA pathological lesions in English literature ( Table 1 ). 1 , 4 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 All had symptoms in the dominant hand, although not listed in the table. The mean age was 24.1 years old (17–35), and six patients were females.…”

Section: Discussionmentioning

confidence: 99%

Posterior circumflex humeral artery pathological lesions with digital ischemia in an elite volleyball player: A case report and literature review

Nishino,

Hiraya,

Yamamoto

et al. 2023

Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilit

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Section: Discussionmentioning

confidence: 99%

Posterior circumflex humeral artery pathological lesions with digital ischemia in an elite volleyball player: A case report and literature review

Nishino,

Hiraya,

Yamamoto

et al. 2023

Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilit

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“…Several studies reported about PCHA pathology with serious ischaemic complications among elite volleyball players [1, 13–24]. Also, multiple cases have been reported in elite baseball pitchers [13, 25–31], tennis players [17, 18, 32], swimmers[33], kayakers[34], yoga practitioners [35], trapeze flying artists [20], American football players [32] and even one in regular work, namely a mechanic [33]. No PCHA pathology was detected in some 350 examined PCHAs of healthy subjects [3, 36, 37].…”

Section: Discussionmentioning

confidence: 99%

Ultrasound assessment of the posterior circumflex humeral artery in elite volleyball players: Aneurysm prevalence, anatomy, branching pattern and vessel characteristics

et al. 2016

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ObjectivesTo determine the prevalence of posterior circumflex humeral artery (PCHA) aneurysms and vessel characteristics of the PCHA and deep brachial artery (DBA) in elite volleyball players.MethodsTwo-hundred and eighty players underwent standardized ultrasound assessment of the dominant arm by a vascular technologist. Assessment included determination of PCHA aneurysms (defined as segmental vessel dilatation ≥150 %), PCHA and DBA anatomy, branching pattern, vessel course and diameter.ResultsThe PCHA and DBA were identified in 100 % and 93 % (260/280) of cases, respectively. The prevalence of PCHA aneurysms was 4.6 % (13/280). All aneurysms were detected in proximal PCHA originating from the axillary artery (AA). The PCHA originated from the AA in 81 % of cases (228/280), and showed a curved course dorsally towards the humeral head in 93 % (211/228). The DBA originated from the AA in 73 % of cases (190/260), and showed a straight course parallel to the AA in 93 % (177/190).ConclusionsPCHA aneurysm prevalence in elite volleyball players is high and associated with a specific branching type: a PCHA that originates from the axillary artery. Radiologists should have a high index of suspicion for this vascular overuse injury. For the first time vessel characteristics and reference values are described to facilitate ultrasound assessment.Key Points• Prevalence of PCHA aneurysms is 4.6 % among elite volleyball players. • All aneurysms are in proximal PCHA that originates directly from AA. • Vessel characteristics and reference values are described to facilitate US assessment. • Mean PCHA and DBA diameters can be used as reference values. • Radiologists need a high index of suspicion for this vascular overuse injury.

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“…Studies among athletes who practice repetitive rotary movements of the shoulder girdle have reported ischemiarelated symptoms of the hand as a result of arterial thoracic outlet syndrome (Reeser, 2007), quadrilateral space syndrome (Reeser, 2007) and aneurysms of the axillary artery (Jackson, 2003) or its branches, like the posterior circumflex humeral artery (PCHA). The majority of aneurysms of the PCHA have been reported in elite volleyball players (Arko, Harris, Zarins, & Olcott, 2001;Atema, Ünlü, Reekers, & Idu, 2012;Brown et al, 2015;Gelabert & Machleder, 1997;Ikezawa et al, 2000;Maas, van Delden, & Reekers, 2004;McIntosh, Hassan, Cherry, & Dahm, 2006;Reekers, Den Hartog, Kuyper, Kromhout, & Peeters, 1993;Reekers & Koedam, 1998;Stänz, Wedler, Köpfli, Künzi, & Pfammatter, 2001;Van de Pol et al, 2012;Vlychou, Spanomichos, Chatziioannou, Georganas, & Zavras, 2001;Volckaert, Geukens, Peers, & Lysens, 2014) and baseball pitchers (Arko et al, 2001;Baumgarten et al, 2007;Duwayri et al, 2011;Kane, Shutze, Vines, & Pearl, 2013;Kee et al, 1995;McCarthy et al, 1989;Nuber, McCarthy, Yao, Schafer, & Suker, 1990;Schneider, Kasparyan, Altchek, Fantini, & Weiland, 1999).…”

Section: Discussionmentioning

confidence: 99%

Test-retest reliability and agreement of the SPI-Questionnaire to detect symptoms of digital ischemia in elite volleyball players

Pol

Zacharian

Maas

et al. 2016

Journal of Sports Sciences

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The Shoulder posterior circumflex humeral artery Pathology and digital Ischemia - questionnaire (SPI-Q) has been developed to enable periodic surveillance of elite volleyball players, who are at risk for digital ischemia. Prior to implementation, assessing reliability is mandatory. Therefore, the test-retest reliability and agreement of the SPI-Q were evaluated among the population at risk. A questionnaire survey was performed with a 2-week interval among 65 elite male volleyball players assessing symptoms of cold, pale and blue digits in the dominant hand during or after practice or competition using a 4-point Likert scale (never, sometimes, often and always). Kappa (κ) and percentage of agreement (POA) were calculated for individual symptoms, and to distinguish symptomatic and asymptomatic players. For the individual symptoms, κ ranged from "poor" (0.25) to "good" (0.63), and POA ranged from "moderate" (78%) to "good" (97%). To classify symptomatic players, the SPI-Q showed "good" reliability (κ = 0.83; 95%CI 0.69-0.97) and "good" agreement (POA = 92%). The current study has proven the SPI-Q to be reliable for detecting elite male indoor volleyball players with symptoms of digital ischemia.

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Upper extremity ischemia in athletes: Embolism from the injured posterior circumflex humeral artery

Cited by 11 publications

References 5 publications

Posterior circumflex humeral artery pathological lesions with digital ischemia in an elite volleyball player: A case report and literature review

Posterior circumflex humeral artery pathological lesions with digital ischemia in an elite volleyball player: A case report and literature review

Ultrasound assessment of the posterior circumflex humeral artery in elite volleyball players: Aneurysm prevalence, anatomy, branching pattern and vessel characteristics

Test-retest reliability and agreement of the SPI-Questionnaire to detect symptoms of digital ischemia in elite volleyball players

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