Shoulder & Elbow Service, Funabashi Orthopaedic Sports Medicine & Joint Center, Funabashi, Japan.
Idota Orthopedic Clinic, Nagoya, Japan.
Am J Sports Med. 2024 Jul;52(9):2314-2318. doi: 10.1177/03635465241259472.
The relationship between abnormalities of the ulnar collateral ligament (UCL) on magnetic resonance imaging (MRI) and elbow symptoms in baseball players remains unclear.
PURPOSE/HYPOTHESIS: This study aimed to compare findings of the UCL on microscopic MRI between asymptomatic and symptomatic elbows in baseball players. We hypothesized that the MRI grade of UCL injuries would exhibit no correlation with medial elbow symptoms in baseball players.
Cross-sectional study; Level of evidence, 3.
The study participants were skeletally mature baseball players who underwent high-resolution microscopic MRI of the medial elbow including for medical checkups. Elbows with previous surgical treatment or traumatic UCL injuries were excluded. The patients were divided into symptomatic and asymptomatic groups. The UCL appearance on microscopic MRI was categorized into 4 grades and compared between the groups. Abnormal findings in the medial elbow including bony fragments at the medial epicondyle, osteophytes or bony fragments in the sublime tubercle, and bone marrow edema (BME) in the sublime tubercle were also evaluated.
A total of 426 baseball players (426 elbows) with a mean age of 20 years (range, 14-41 years) were included. The asymptomatic and symptomatic groups included 158 and 268 elbows, respectively. In the asymptomatic group, based on MRI grading of the UCL, 46 (29%) elbows were rated as grade I, 64 (41%) as grade II, 40 (25%) as grade III, and 8 (5%) as grade IV. In the symptomatic group, 75 (28%) elbows were rated as grade I, 118 (44%) as grade II, 61 (23%) as grade III, and 14 (5%) as grade IV. There was no significant difference in the MRI grades between the groups ( = .9). BME in the sublime tubercle was more frequently seen in the symptomatic group than in the asymptomatic group ( < .001).
There was no difference in MRI grades of the UCL between symptomatic and asymptomatic elbows in baseball players; approximately 30% of elbows demonstrated high-grade UCL injuries in both groups. BME in the sublime tubercle was more frequently seen in symptomatic elbows than in asymptomatic elbows. BME in the sublime tubercle was a better indicator of symptoms than was MRI grading of the UCL.
在棒球运动员中，磁共振成像（MRI）上肘尺侧副韧带（UCL）异常与肘部症状之间的关系尚不清楚。
目的/假设：本研究旨在比较棒球运动员无症状和有症状肘部 UCL 的微观 MRI 检查结果。我们假设 UCL 损伤的 MRI 分级与棒球运动员的内侧肘部症状之间没有相关性。
横断面研究；证据水平，3 级。
研究参与者为接受内侧肘部高分辨率微观 MRI 检查的骨骼成熟棒球运动员，这些检查是为了进行医学检查。排除有既往手术治疗或创伤性 UCL 损伤的肘部。患者分为有症状和无症状两组。将 UCL 在微观 MRI 上的表现分为 4 个等级，并在两组之间进行比较。还评估了内侧肘部的异常发现，包括内侧上髁的骨碎片、骨赘或骨碎片在崇高结节，和骨髓水肿（BME）在崇高结节。
共纳入 426 名棒球运动员（426 只肘部），平均年龄 20 岁（范围 14-41 岁）。无症状组和有症状组分别包括 158 只和 268 只肘部。在无症状组中，根据 UCL 的 MRI 分级，46（29%）只肘部为 I 级，64（41%）为 II 级，40（25%）为 III 级，8（5%）为 IV 级。在有症状组中，75（28%）只肘部为 I 级，118（44%）为 II 级，61（23%）为 III 级，14（5%）为 IV 级。两组之间的 MRI 分级无显著差异（=.9）。有症状组比无症状组更常出现崇高结节的 BME（<.001）。
在棒球运动员中，有症状和无症状肘部的 UCL 的 MRI 分级没有差异；两组中约 30%的肘部出现高级 UCL 损伤。有症状肘部比无症状肘部更常出现崇高结节的 BME。崇高结节的 BME 是肘部症状的一个更好的指标，优于 UCL 的 MRI 分级。
