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Do magnetic resonance imaging abnormalities of the non-dominant wrist correlate with ulnar-sided wrist pain in elite tennis players?

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Abstract

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.

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Acknowledgements

The authors would like to acknowledge the invaluable assistance of the staff at Victoria House Medical Imaging and Tennis Australia in performing magnetic resonance imaging studies on and interviewing members of the study population.

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Authors and Affiliations

  1. Victoria House Medical Imaging, I-MED Radiology Network, Melbourne, Victoria, Australia

    Sidney M. Levy, Elissa Botterill, Frank Malara & Andrew H. Rotstein

  2. Department of Diagnostic Imaging, Monash Health, Melbourne, Victoria, Australia

    Sidney M. Levy

  3. Tennis Australia, Melbourne, Victoria, Australia

    Machar Reid, Anne-Marie Montgomery, Stephanie A. Kovalchik, Melanie Omizzolo & Timothy O. Wood

  4. University of Western Australia, Perth, Western Australia, Australia

    Machar Reid

  5. Institute of Exercise, Sport and Active Living, Victoria University, Melbourne, Victoria, Australia

    Stephanie A. Kovalchik

  6. Melbourne Orthopaedic Group, Melbourne, Victoria, Australia

    Gregory A. Hoy

  7. Department of Surgery, Monash University, Melbourne, Victoria, Australia

    Gregory A. Hoy

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  1. Sidney M. Levy
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  2. Machar Reid
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  3. Anne-Marie Montgomery
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Corresponding author

Correspondence to Sidney M. Levy.

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All procedures performed in this study were in accordance with the ethical standards of the 1964 Helsinki Declaration and its later amendments.

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The authors declare that they have no conflicts of interest with the publication of this article.

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Informed consent was obtained from all individual participants included in the study.

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Sidney Levy and Machar Reid are equal first authors.

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Levy, S.M., Reid, M., Montgomery, AM. et al. Do magnetic resonance imaging abnormalities of the non-dominant wrist correlate with ulnar-sided wrist pain in elite tennis players?. Skeletal Radiol 49, 407–415 (2020). https://doi.org/10.1007/s00256-019-03285-y

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  • DOI: https://doi.org/10.1007/s00256-019-03285-y

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