Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Department of Diagnostic and Interventional Radiology, Faculty of Medicine, University of Tsukuba, MD 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan.
Skeletal Radiol. 2019 Dec;48(12):1925-1932. doi: 10.1007/s00256-019-03231-y. Epub 2019 May 23.
Elbow screening of adolescent baseball players began in 2014 using ultrasound, palpation, and dedicated magnetic resonance imaging (MRI). We frequently encountered subjects showing MCL injury on MRI but no clinical symptoms. We assessed variations in asymptomatic MCL injury findings at follow-up MRI, and clarified the pathogenesis of these findings.
Using a 0.2-T-dedicated MRI, 30 subjects with asymptomatic MCL injury at initial MRI who agreed to follow-up MRI were included. We classified the findings at repeat MRI as follows: (a) disappeared, (b) better, and (c) worse.
There were 6, 16, and 8 subjects in groups a, b, and c, respectively. The average age at follow-up was 14.0, 12.1, and 12.4 years in groups a, b, and c, respectively. There were significant differences between groups a and b and between groups a and c. Average height at follow-up of groups a, b, and c was 1.64, 1.52, and 1.57 cm, respectively, with a statistically significant difference between groups a and b. The average size of the short axis of the MCL of subjects in group a was 2.0 cm on the dominant side and 1.5 cm on the contradominant side (P < 0.04).
Players with asymptomatic MCL injury can continue to play baseball with no limitations, as these findings usually disappear around the age of 14.0 years, when the growth spurt occurs. This finding may be a precursor of 'adaptation', which is generally observed in high school baseball players, suggesting that the MCL adapts as growth occurs.
2014 年开始使用超声、触诊和专用磁共振成像(MRI)对青少年棒球运动员的肘部进行筛查。我们经常在 MRI 上发现有前交叉韧带(MCL)损伤但无临床症状的患者。我们评估了随诊 MRI 中无症状 MCL 损伤表现的变化,并阐明了这些发现的发病机制。
使用 0.2-T 专用 MRI,纳入 30 例初次 MRI 显示无症状 MCL 损伤且同意随诊 MRI 的患者。我们将重复 MRI 的发现分为以下几类:(a)消失,(b)改善,和(c)恶化。
a、b 和 c 组分别有 6、16 和 8 例患者。a、b 和 c 组的平均随访年龄分别为 14.0、12.1 和 12.4 岁。a 组与 b 组以及 a 组与 c 组之间存在显著差异。a、b 和 c 组的平均随访身高分别为 1.64、1.52 和 1.57cm,a 组与 b 组之间存在统计学差异。a 组患者 MCL 短轴的平均直径在优势侧为 2.0cm,在对侧为 1.5cm(P<0.04)。
无症状 MCL 损伤的运动员可以继续不受限制地打棒球,因为这些发现通常在 14 岁左右生长突增时消失。这一发现可能是“适应”的前兆,在高中棒球运动员中普遍观察到,表明随着生长发生,MCL 会发生适应性变化。