Beletsky Alexander, Okoroha Kelechi R, Cabarcas Brandon, Garcia Grant H, Gowd Anirudh K, Meyer John, Vadhera Amar S, Singh Harsh, Gursoy Safa, White Gregory M, Davidson James, Nicholson Gregory P, Chahla Jorge, Verma Nikhil N
University of California, San Diego School of Medicine, La Jolla, CA, U.S.A.
Division of Sports Medicine, Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, IL, U.S.A.
Arthrosc Sports Med Rehabil. 2022 Feb 16;4(2):e487-e493. doi: 10.1016/j.asmr.2021.10.029. eCollection 2022 Apr.
To evaluate preseason shoulder magnetic resonance images (MRIs) obtained from pitchers entering either major or minor league baseball (MLB) and correlate findings with subsequent injury, operative repair, and placement on the injured list (IL).
Preseason-MRI of the throwing shoulders of professional-level baseball pitchers, taken during routine evaluations at a single organization (2004-2017) were retrospectively reviewed. Publicly available databases were queried to exclude pitchers with known injuries prior to pre-signing imaging. Three blinded reviewers reviewed all MRI scans independently to evaluate for the presence of abnormalities in the rotator cuff (RTC), labrum, capsule, long-head of the biceps tendon (LHBT), and humeral head. Binary imaging findings were correlated to future placement on the IL for subsequent shoulder complaints. Bivariate statistics using Student's -tests and Fisher exact tests (both α = .05) were used in this study.
A total of 38 asymptomatic pitchers with shoulder MRIs were included. Pitchers had a mean (±SD) age of 28.2 ± 4.9 and had pitched an average of 119.6 ± 143.8 career games. Pitchers with partial articular-sided RTC tears ( = .04) or intra-articular BT hyperintensity ( = .04) on preseason MRI demonstrated an association with the need for future surgery. Pitchers with evidence of labral heterogeneity demonstrated greater total career pitch counts (10,034.1 vs 2,465.3; = .04). Evidence of a posterior-superior humeral cyst was associated with decreased strikeouts per 9 innings (6.1 vs 8.0; = .039) and total strikeout percentage (16.1% vs 23.2%; = .04).
Although there was a significant difference in the percent of various radiographic findings between the injured and healthy cohort, no MRI findings were predictive of future IL placement or duration of placement. The presence of a posterior superior humeral cyst was associated with decreased strikeout rates at 2 and 3 years, the presence of a labral tear was associated with decreased earned run average (ERA) at 3 years and decreased career strikeout percentages, and increased capsular signal was associated with decreased 5-year ERA.
Level IV, retrospective study.
评估进入美国职业棒球大联盟（MLB）或小联盟的投手的季前肩部磁共振成像（MRI），并将结果与随后的损伤、手术修复以及进入伤病名单（IL）的情况相关联。
回顾性分析了在一个机构（2004 - 2017年）进行常规评估期间，职业水平棒球投手投掷肩部的季前MRI。查询公开可用数据库以排除在签约前成像前已知有损伤的投手。三名盲法审阅者独立审阅所有MRI扫描，以评估肩袖（RTC）、盂唇、关节囊、肱二头肌长头肌腱（LHBT）和肱骨头是否存在异常。将二元成像结果与随后因肩部不适进入IL的情况相关联。本研究使用了Student's -检验和Fisher精确检验的双变量统计（α均 = 0.05）。
共纳入38名肩部MRI无症状的投手。投手的平均（±标准差）年龄为28.2 ± 4.9岁，职业生涯平均投球119.6 ± 143.8场比赛。季前MRI显示部分关节侧RTC撕裂（ = 0.04）或关节内BT高信号（ = 0.04）的投手与未来需要手术相关。有盂唇异质性证据的投手职业生涯总投球数更多（10,034. vs 2,465.3； = 0.04）。肱骨头后上方囊肿的证据与每9局三振次数减少（6.1对8.0； = 0.039）和总三振百分比降低（16.1%对23.2%； = 0.04）相关。
尽管受伤队列和健康队列之间各种影像学表现的百分比存在显著差异，但没有MRI表现能够预测未来进入IL的情况或在IL的停留时间。肱骨头后上方囊肿的存在与2年和3年时三振率降低相关，盂唇撕裂的存在与3年时平均责任失分（ERA）降低和职业生涯三振百分比降低相关，关节囊信号增强与5年ERA降低相关。
IV级，回顾性研究。
