Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123, Dapi Road, Niaosong District, Kaohsiung, Taiwan, Republic of China.
Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China.
Knee Surg Sports Traumatol Arthrosc. 2019 Oct;27(10):3261-3268. doi: 10.1007/s00167-018-5178-x. Epub 2018 Oct 3.
Only few studies have investigated medial epicondyle (MEC) lesions, particularly in the 12-18 age group. To the best of our knowledge, no study has compared ultrasonography (US), radiography and magnetic resonance imaging (MRI) in detecting MEC lesions. The aims of this study were to examine the value of US for detecting MEC lesions and to investigate correlations among diagnostic tools.
A prospective, comparative study was performed. Young baseball players from southern Taiwan were recruited, and basic characteristics, as well as passive range of motion (pROM) of the upper extremities, were recorded. Screening US was performed to identify MEC lesions, and players with MEC lesions received follow-up plain radiography and MRI.
A total of 299 young baseball players were screened using US, and 28 of 299 players with possible MEC lesions were identified with a positive predictive value (PPV) of 88% according to MRI findings. The MEC lesions were primarily comprised of unfused ossicles and bony fragmentation. Other diagnoses, including UCL strain and medial epicondylitis, were also found by MRI in players with abnormal US screening results. The pROM of shoulder external rotation (ER) of the throwing hand was significantly reduced in players with MEC lesions (p = 0.006).
Bony cortical discontinuity or fragmentation over the MEC warrants further research, and US provides good PPV for types of MEC lesions. Decreased shoulder ER may relate to MEC lesions and should be taken into consideration. The use of US may facilitate early detection and intervention.
IV, Cross-sectional study.
仅有少数研究调查了肱骨内上髁（MEC）病变，特别是在 12-18 岁年龄组。据我们所知，尚无研究比较超声（US）、放射线照相术和磁共振成像（MRI）在检测 MEC 病变中的作用。本研究的目的是检查 US 检测 MEC 病变的价值，并研究诊断工具之间的相关性。
进行了一项前瞻性的比较研究。招募了来自台湾南部的年轻棒球运动员，并记录了基本特征以及上肢的被动活动范围（pROM）。进行了筛选性超声检查以识别 MEC 病变，并且患有 MEC 病变的运动员接受了后续的普通放射线照相术和 MRI 检查。
共有 299 名年轻棒球运动员接受了 US 筛查，根据 MRI 检查结果，299 名运动员中有 28 名被确定为可能的 MEC 病变，阳性预测值（PPV）为 88％。MEC 病变主要由未融合的籽骨和骨碎片组成。在 US 筛查结果异常的运动员中，MRI 还发现了其他诊断，包括 UCL 劳损和内侧腱鞘炎。患有 MEC 病变的运动员的肩部外旋（ER）pROM 明显降低（p=0.006）。
MEC 上的骨皮质连续性或碎裂需要进一步研究，US 对 MEC 病变具有良好的 PPV。肩部 ER 的减少可能与 MEC 病变有关，应加以考虑。US 的使用可能有助于早期发现和干预。
IV，横断面研究。
