Magnetic Resonance Imaging Abnormalities in the Shoulder and Wrist Joints of Asymptomatic Elite Athletes

Objective To characterize abnormalities on magnetic resonance images (MRI) in the shoulder and wrist joints of asymptomatic elite athletes to better define the range of “normal” findings in this population. Design Cohort study. Setting Academic medical center. Subjects Division IA collegiate volleyb...

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Veröffentlicht in:PM & R 2009-02, Vol.1 (2), p.107-116
Hauptverfasser: Fredericson, Michael, MD, Ho, Charles, MD, PhD, Waite, Brandee, MD, Jennings, Fabio, MD, Peterson, Jeffrey, MD, Williams, Christina, Mathesonn, Gordon O., MD, PhD
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container_end_page 116
container_issue 2
container_start_page 107
container_title PM & R
container_volume 1
creator Fredericson, Michael, MD
Ho, Charles, MD, PhD
Waite, Brandee, MD
Jennings, Fabio, MD
Peterson, Jeffrey, MD
Williams, Christina
Mathesonn, Gordon O., MD, PhD
description Objective To characterize abnormalities on magnetic resonance images (MRI) in the shoulder and wrist joints of asymptomatic elite athletes to better define the range of “normal” findings in this population. Design Cohort study. Setting Academic medical center. Subjects Division IA collegiate volleyball players (n=12), swimmers (n=6), and gymnasts (n=15) with no history of injury or pain and normal physical examination results. Interventions None. Main Outcome Measures Grade of severity of MRI changes of the shoulder and wrist joints. A 3- to 4-year follow-up questionnaire was administered to determine the clinical significance of the asymptomatic findings. Results All athletes demonstrated at least mild imaging abnormalities in the joints evaluated. Shoulder: Volleyball players had moderate and severe changes primarily in the labrum (50% moderate, 8% severe), rotator cuff (25% moderate, 17% severe), bony structures (33% moderate), and tendon/muscle (25% moderate, 8% severe). Swimmers had moderate changes primarily in the labrum (83% moderate) and ligament (67% moderate). Wrist: All gymnasts had changes in the wrist ligaments (40% mild, 60% moderate), tendons (53% mild, 47% moderate), and cartilage (60% mild, 33% moderate, 7% severe). Most gymnasts exhibited bony changes (20% normal, 47% mild, 26% moderate, 7% severe), the presence of cysts/fluid collections (80%), and carpal tunnel changes (53%). Swimmers had no wrist abnormalities. At follow-up interview, only 1 swimmer and 1 volleyball player reported shoulder problems during the study. Additionally, only 1 gymnast reported a wrist injury during their career. Conclusion Asymptomatic elite athletes demonstrate MRI changes of the shoulder (swimmers and volleyball players) and wrist (gymnasts) similar to those associated with abnormalities for which medical treatment and sometimes surgery are advised. Given the somewhat high frequency of these asymptomatic findings, care must be taken to correlate clinical history and physical examination with MRI findings in these patients with symptoms.
doi_str_mv 10.1016/j.pmrj.2008.09.004
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Design Cohort study. Setting Academic medical center. Subjects Division IA collegiate volleyball players (n=12), swimmers (n=6), and gymnasts (n=15) with no history of injury or pain and normal physical examination results. Interventions None. Main Outcome Measures Grade of severity of MRI changes of the shoulder and wrist joints. A 3- to 4-year follow-up questionnaire was administered to determine the clinical significance of the asymptomatic findings. Results All athletes demonstrated at least mild imaging abnormalities in the joints evaluated. Shoulder: Volleyball players had moderate and severe changes primarily in the labrum (50% moderate, 8% severe), rotator cuff (25% moderate, 17% severe), bony structures (33% moderate), and tendon/muscle (25% moderate, 8% severe). Swimmers had moderate changes primarily in the labrum (83% moderate) and ligament (67% moderate). Wrist: All gymnasts had changes in the wrist ligaments (40% mild, 60% moderate), tendons (53% mild, 47% moderate), and cartilage (60% mild, 33% moderate, 7% severe). Most gymnasts exhibited bony changes (20% normal, 47% mild, 26% moderate, 7% severe), the presence of cysts/fluid collections (80%), and carpal tunnel changes (53%). Swimmers had no wrist abnormalities. At follow-up interview, only 1 swimmer and 1 volleyball player reported shoulder problems during the study. Additionally, only 1 gymnast reported a wrist injury during their career. Conclusion Asymptomatic elite athletes demonstrate MRI changes of the shoulder (swimmers and volleyball players) and wrist (gymnasts) similar to those associated with abnormalities for which medical treatment and sometimes surgery are advised. Given the somewhat high frequency of these asymptomatic findings, care must be taken to correlate clinical history and physical examination with MRI findings in these patients with symptoms.</description><identifier>ISSN: 1934-1482</identifier><identifier>EISSN: 1934-1563</identifier><identifier>DOI: 10.1016/j.pmrj.2008.09.004</identifier><identifier>PMID: 19627884</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; Athletic Injuries - pathology ; Cohort Studies ; Cumulative Trauma Disorders - etiology ; Cumulative Trauma Disorders - pathology ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Physical Medicine and Rehabilitation ; Severity of Illness Index ; Sex Factors ; Shoulder Joint - pathology ; Wrist Joint - pathology ; Young Adult</subject><ispartof>PM &amp; R, 2009-02, Vol.1 (2), p.107-116</ispartof><rights>American Academy of Physical Medicine and Rehabilitation</rights><rights>2009 American Academy of Physical Medicine and Rehabilitation</rights><rights>2009 by the American Academy of Physical Medicine and Rehabilitation</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4577-58e6bad4d7b29f4ed302d64f2016bb4979de7302a6618e392ddb7d61ce860d3</citedby><cites>FETCH-LOGICAL-c4577-58e6bad4d7b29f4ed302d64f2016bb4979de7302a6618e392ddb7d61ce860d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1016%2Fj.pmrj.2008.09.004$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1016%2Fj.pmrj.2008.09.004$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19627884$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fredericson, Michael, MD</creatorcontrib><creatorcontrib>Ho, Charles, MD, PhD</creatorcontrib><creatorcontrib>Waite, Brandee, MD</creatorcontrib><creatorcontrib>Jennings, Fabio, MD</creatorcontrib><creatorcontrib>Peterson, Jeffrey, MD</creatorcontrib><creatorcontrib>Williams, Christina</creatorcontrib><creatorcontrib>Mathesonn, Gordon O., MD, PhD</creatorcontrib><title>Magnetic Resonance Imaging Abnormalities in the Shoulder and Wrist Joints of Asymptomatic Elite Athletes</title><title>PM &amp; R</title><addtitle>PM R</addtitle><description>Objective To characterize abnormalities on magnetic resonance images (MRI) in the shoulder and wrist joints of asymptomatic elite athletes to better define the range of “normal” findings in this population. Design Cohort study. Setting Academic medical center. Subjects Division IA collegiate volleyball players (n=12), swimmers (n=6), and gymnasts (n=15) with no history of injury or pain and normal physical examination results. Interventions None. Main Outcome Measures Grade of severity of MRI changes of the shoulder and wrist joints. A 3- to 4-year follow-up questionnaire was administered to determine the clinical significance of the asymptomatic findings. Results All athletes demonstrated at least mild imaging abnormalities in the joints evaluated. Shoulder: Volleyball players had moderate and severe changes primarily in the labrum (50% moderate, 8% severe), rotator cuff (25% moderate, 17% severe), bony structures (33% moderate), and tendon/muscle (25% moderate, 8% severe). Swimmers had moderate changes primarily in the labrum (83% moderate) and ligament (67% moderate). Wrist: All gymnasts had changes in the wrist ligaments (40% mild, 60% moderate), tendons (53% mild, 47% moderate), and cartilage (60% mild, 33% moderate, 7% severe). Most gymnasts exhibited bony changes (20% normal, 47% mild, 26% moderate, 7% severe), the presence of cysts/fluid collections (80%), and carpal tunnel changes (53%). Swimmers had no wrist abnormalities. At follow-up interview, only 1 swimmer and 1 volleyball player reported shoulder problems during the study. Additionally, only 1 gymnast reported a wrist injury during their career. Conclusion Asymptomatic elite athletes demonstrate MRI changes of the shoulder (swimmers and volleyball players) and wrist (gymnasts) similar to those associated with abnormalities for which medical treatment and sometimes surgery are advised. Given the somewhat high frequency of these asymptomatic findings, care must be taken to correlate clinical history and physical examination with MRI findings in these patients with symptoms.</description><subject>Adolescent</subject><subject>Athletic Injuries - pathology</subject><subject>Cohort Studies</subject><subject>Cumulative Trauma Disorders - etiology</subject><subject>Cumulative Trauma Disorders - pathology</subject><subject>Female</subject><subject>Humans</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Physical Medicine and Rehabilitation</subject><subject>Severity of Illness Index</subject><subject>Sex Factors</subject><subject>Shoulder Joint - pathology</subject><subject>Wrist Joint - pathology</subject><subject>Young Adult</subject><issn>1934-1482</issn><issn>1934-1563</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkkFrFDEYhgex2Fr9Ax4kJ287JjPZJAMiLKVqS0ulK-gtZJJvdjPOJNsko-y_N8OuFDxITwnhfV7yPUlRvCG4JJiw9325G0NfVhiLEjclxvRZcUaami7IktXP_-6pqE6LlzH2GDNKBHtRnJKGVVwIelZsb9XGQbIa3UP0TjkN6GpUG-s2aNU6H0Y12GQhIutQ2gJab_00GAhIOYO-BxsTuvbWpYh8h1ZxP-6SH9VceJlBQKu0HSBBfFWcdGqI8Pq4nhfrT5ffLr4sbu4-X12sbhaaLjlfLAWwVhlqeFs1HQVT48ow2lV54LalDW8M8HymGCMC6qYypuWGEQ2CYVOfF-8OrbvgHyaISY42ahgG5cBPUTK-nGdnOVgdgjr4GAN0chfsqMJeEixnu7KXs10525W4kdluht4e26d2BPOIHHXmAD8EftsB9k-olF9v768J5pn8cCAhu_llIcioLeTXMDaATtJ4-_-bffwH14N1VqvhJ-wh9n4KLluXRMZKYrmef8b8MbDAGBPxo_4D8Aay7w</recordid><startdate>200902</startdate><enddate>200902</enddate><creator>Fredericson, Michael, MD</creator><creator>Ho, Charles, MD, PhD</creator><creator>Waite, Brandee, MD</creator><creator>Jennings, Fabio, MD</creator><creator>Peterson, Jeffrey, MD</creator><creator>Williams, Christina</creator><creator>Mathesonn, Gordon O., MD, PhD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200902</creationdate><title>Magnetic Resonance Imaging Abnormalities in the Shoulder and Wrist Joints of Asymptomatic Elite Athletes</title><author>Fredericson, Michael, MD ; Ho, Charles, MD, PhD ; Waite, Brandee, MD ; Jennings, Fabio, MD ; Peterson, Jeffrey, MD ; Williams, Christina ; Mathesonn, Gordon O., MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4577-58e6bad4d7b29f4ed302d64f2016bb4979de7302a6618e392ddb7d61ce860d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adolescent</topic><topic>Athletic Injuries - pathology</topic><topic>Cohort Studies</topic><topic>Cumulative Trauma Disorders - etiology</topic><topic>Cumulative Trauma Disorders - pathology</topic><topic>Female</topic><topic>Humans</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Physical Medicine and Rehabilitation</topic><topic>Severity of Illness Index</topic><topic>Sex Factors</topic><topic>Shoulder Joint - pathology</topic><topic>Wrist Joint - pathology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fredericson, Michael, MD</creatorcontrib><creatorcontrib>Ho, Charles, MD, PhD</creatorcontrib><creatorcontrib>Waite, Brandee, MD</creatorcontrib><creatorcontrib>Jennings, Fabio, MD</creatorcontrib><creatorcontrib>Peterson, Jeffrey, MD</creatorcontrib><creatorcontrib>Williams, Christina</creatorcontrib><creatorcontrib>Mathesonn, Gordon O., MD, PhD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>PM &amp; R</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fredericson, Michael, MD</au><au>Ho, Charles, MD, PhD</au><au>Waite, Brandee, MD</au><au>Jennings, Fabio, MD</au><au>Peterson, Jeffrey, MD</au><au>Williams, Christina</au><au>Mathesonn, Gordon O., MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Magnetic Resonance Imaging Abnormalities in the Shoulder and Wrist Joints of Asymptomatic Elite Athletes</atitle><jtitle>PM &amp; R</jtitle><addtitle>PM R</addtitle><date>2009-02</date><risdate>2009</risdate><volume>1</volume><issue>2</issue><spage>107</spage><epage>116</epage><pages>107-116</pages><issn>1934-1482</issn><eissn>1934-1563</eissn><abstract>Objective To characterize abnormalities on magnetic resonance images (MRI) in the shoulder and wrist joints of asymptomatic elite athletes to better define the range of “normal” findings in this population. Design Cohort study. Setting Academic medical center. Subjects Division IA collegiate volleyball players (n=12), swimmers (n=6), and gymnasts (n=15) with no history of injury or pain and normal physical examination results. Interventions None. Main Outcome Measures Grade of severity of MRI changes of the shoulder and wrist joints. A 3- to 4-year follow-up questionnaire was administered to determine the clinical significance of the asymptomatic findings. Results All athletes demonstrated at least mild imaging abnormalities in the joints evaluated. Shoulder: Volleyball players had moderate and severe changes primarily in the labrum (50% moderate, 8% severe), rotator cuff (25% moderate, 17% severe), bony structures (33% moderate), and tendon/muscle (25% moderate, 8% severe). Swimmers had moderate changes primarily in the labrum (83% moderate) and ligament (67% moderate). Wrist: All gymnasts had changes in the wrist ligaments (40% mild, 60% moderate), tendons (53% mild, 47% moderate), and cartilage (60% mild, 33% moderate, 7% severe). Most gymnasts exhibited bony changes (20% normal, 47% mild, 26% moderate, 7% severe), the presence of cysts/fluid collections (80%), and carpal tunnel changes (53%). Swimmers had no wrist abnormalities. At follow-up interview, only 1 swimmer and 1 volleyball player reported shoulder problems during the study. Additionally, only 1 gymnast reported a wrist injury during their career. Conclusion Asymptomatic elite athletes demonstrate MRI changes of the shoulder (swimmers and volleyball players) and wrist (gymnasts) similar to those associated with abnormalities for which medical treatment and sometimes surgery are advised. Given the somewhat high frequency of these asymptomatic findings, care must be taken to correlate clinical history and physical examination with MRI findings in these patients with symptoms.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>19627884</pmid><doi>10.1016/j.pmrj.2008.09.004</doi><tpages>10</tpages></addata></record>
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subjects Adolescent
Athletic Injuries - pathology
Cohort Studies
Cumulative Trauma Disorders - etiology
Cumulative Trauma Disorders - pathology
Female
Humans
Magnetic Resonance Imaging
Male
Physical Medicine and Rehabilitation
Severity of Illness Index
Sex Factors
Shoulder Joint - pathology
Wrist Joint - pathology
Young Adult
title Magnetic Resonance Imaging Abnormalities in the Shoulder and Wrist Joints of Asymptomatic Elite Athletes
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