Delgado Jorge, Jaramillo Diego, Chauvin Nancy A
From the Department of Radiology, Children's Hospital of Philadelphia, 34th St and Civic Center Blvd, Philadelphia, PA 19104 (J.D., N.A.C.); Department of Radiology, Stanford University Medical Center, Palo Alto, Calif (D.J.); and Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa (N.A.C.).
Radiographics. 2016 Oct;36(6):1672-1687. doi: 10.1148/rg.2016160036.
Increased physical activity in childhood has resulted in a large number of sports-related injuries. Although there is overlap between the sports-related injuries seen in pediatric and adult patients, important differences exist in the injury patterns of pediatric patients. These differences are related to the continuous changes in the developing skeleton and its relationship with adjacent soft tissues. The imbalance in strength between the growing bones and the nearby tendons and ligaments makes the bones prone to acute and chronic injuries. Acute injuries are more common in contact sports such as football and wrestling, whereas chronic injuries are often seen in baseball pitchers and gymnasts. Acute injuries unique to pediatric athletes include physeal fractures of the proximal and distal portions of the clavicle (periosteal sleeve fracture), the proximal humeral physis, and the coracoid process, as well as supracondylar, lateral condylar, and medial condylar fractures around the elbow. Chronic injuries, most commonly caused by repetitive microtrauma, include acromial apophyseolysis, Little Leaguer's shoulder, the constellation of findings seen in Little Leaguer's elbow, and injuries to the medial, lateral, and posterior elbow compartments. In addition, trochlear osteochondral lesions, gymnast's wrist, and rock climber's finger are less-common injuries that may be seen in children. In this article, the normal osseous development of the upper extremity is reviewed, with emphasis on the structures that are most commonly injured. The pathophysiology, imaging appearance, and imaging findings of pediatric athletic injuries are described, along with the prognostic implications. RSNA, 2016.
儿童期体力活动的增加导致了大量与运动相关的损伤。尽管儿科和成年患者中所见的与运动相关的损伤存在重叠，但儿科患者的损伤模式存在重要差异。这些差异与发育中的骨骼及其与相邻软组织的关系的持续变化有关。生长中的骨骼与附近肌腱和韧带之间的力量失衡使骨骼容易发生急性和慢性损伤。急性损伤在足球和摔跤等接触性运动中更为常见，而慢性损伤则常见于棒球投手和体操运动员。儿科运动员特有的急性损伤包括锁骨近端和远端的骨骺骨折（骨膜袖套骨折）、肱骨近端骨骺以及喙突，以及肘部周围的髁上骨折、外侧髁骨折和内侧髁骨折。慢性损伤最常见于重复性微创伤，包括肩峰骨骺溶解、小联盟肩、小联盟肘所见的一系列表现，以及肘部内侧、外侧和后部的损伤。此外，滑车骨软骨损伤、体操运动员腕和攀岩者手指是儿童中可能出现的较少见损伤。本文回顾了上肢的正常骨骼发育，重点关注最常受伤的结构。描述了儿科运动损伤的病理生理学、影像学表现和影像学发现，以及预后意义。RSNA，2016年。
