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Do magnetic resonance imaging abnormalities of the non-dominant wrist correlate with ulnar-sided wrist pain in elite tennis players?
Skeletal Radiology ( IF 1.9 ) Pub Date : 2019-08-10 , DOI: 10.1007/s00256-019-03285-y
Sidney M Levy 1, 2 , Machar Reid 3, 4 , Anne-Marie Montgomery 3 , Elissa Botterill 1 , Stephanie A Kovalchik 3, 5 , Melanie Omizzolo 3 , Frank Malara 1 , Timothy O Wood 3 , Gregory A Hoy 6, 7 , Andrew H Rotstein 1
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OBJECTIVE Ulnar-sided injuries of the non-dominant wrist are common in elite tennis players that use the double-handed backhand technique. This study aimed to define the relationship between ulnar-sided wrist pain in symptomatic and asymptomatic elite tennis players, and the presence of abnormalities on magnetic resonance imaging (MRI). MATERIALS AND METHODS Fourteen symptomatic tennis players, 14 asymptomatic tennis players, and 12 healthy controls who did not play tennis, were analyzed prospectively, after undergoing MRI of their non-dominant wrist. Five anatomical regions were analyzed, thought to relate to ulnar-sided wrist pain. These consisted of the triangular fibrocartilage complex (TFCC), ulnar collateral ligament (UCL), extensor carpi ulnaris tendon (ECU), osseous-articular structures, and ganglia. Images were independently reviewed by two blinded musculoskeletal radiologists. RESULTS Non-dominant, ulnar-sided, wrist pain in elite tennis players was not statistically significantly associated with an increased number of MRI abnormalities when compared with asymptomatic tennis players (p > 0.05). However, some evidence of statistical association was seen with an increased prevalence of ECU tendon abnormalities (OR = 8.0, 95% CI = (0.74, 20.00), p = 0.07). A statistically significant increase in MRI abnormalities of osseous structures (OR = 15.1, 95% CI = (1.56, 656.05), p = 0.02) and the dorsal radioulnar ligament (DRUL) (OR = 12.5, 95% CI = (2.15, 111.11), p = 0.03), was observed in symptomatic players compared with controls. CONCLUSIONS Non-dominant, ulnar-sided, wrist pain in a subgroup of elite tennis players using a double-handed backhand technique is not associated with a statistically significant increased prevalence of MRI abnormalities when compared with asymptomatic tennis players, other than some evidence of statistical association with ECU tendon abnormalities. Therefore, significance of MRI abnormalities should be interpreted in the context of clinical findings.

中文翻译:

非主要腕部的磁共振成像异常是否与精英网球运动员的尺侧腕部疼痛相关?

目的使用双手反手技术的精英网球运动员常见腕部尺侧受伤。这项研究旨在确定有症状和无症状的精英网球运动员的尺侧腕痛与磁共振成像(MRI)异常之间的关系。材料与方法对14名有症状的网球运动员,14名无症状的网球运动员和12名没有打网球的健康对照组进行了前臂MRI检查后,对其进行了前瞻性分析。分析了五个解剖区域,认为与尺侧腕痛有关。这些包括三角形纤维软骨复合物(TFCC),尺侧副韧带(UCL),腕腕尺腱(ECU),骨关节结构和神经节。图像由两名盲目肌肉骨骼放射科医生独立审查。结果与无症状网球运动员相比,精英网球运动员的非支配性,尺侧腕部疼痛与MRI异常增加之间无统计学显着相关性(p> 0.05)。然而,一些证据表明,与ECU肌腱异常的患病率增加相关(OR = 8.0,95%CI =(0.74,20.00),p = 0.07)。骨结构的MRI异常(OR = 15.1,95%CI =(1.56,656.05),p = 0.02)和背侧尺li韧带(DRUL)的统计学显着增加(OR = 12.5,95%CI =(2.15,111.11) ),p = 0.03),与对照组相比,在有症状球员中观察到。结论:非优势,尺侧,与无症状网球运动员相比,使用双手反手技术的一组精英网球运动员的腕部疼痛与MRI异常的发生率在统计学上没有显着相关性,除了一些证据表明与ECU肌腱异常有统计学联系。因此,应在临床发现的背景下解释MRI异常的重要性。
更新日期:2020-01-21
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