Michael K Drew1, Larissa Trease2, J P Caneiro3, Ivan Hooper4, Chin-Chin Ooi5, Peter Counsel6, David A Connell7, Anthony A Rice8, Emma Knight9, Gregory Hoy10, Gregory Lovell11. 1. Department of Physical Therapies, Australian Institute of Sport, Australia; Department of Physiotherapy, Faculty of Health, University of Canberra, Australia; Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University, Australia. Electronic address: Michael.drew@ausport.gov.au. 2. Department of Sports Medicine, Rowing Australia, Australia. 3. Department of Physiotherapy, Curtin University, Australia. 4. Department of Physical Therapies, Australian Institute of Sport, Australia. 5. Department of Diagnostic Radiology, Singapore General Hospital, Singapore; Department of Diagnostic Radiology, Monash University, Australia. 6. Imaging at Olympic Park, Australia. 7. Imaging at Olympic Park, Australia; Department of Medicine, Nursing and Healthcare, Monash University, Australia. 8. Department of Physiology, Australian Institute of Sport, Australia. 9. Department of Performance Research, Australian Institute of Sport, Australia. 10. Melbourne Orthopaedic Group, Australia. 11. Department of Sports Medicine, Australian Institute of Sport, Australia.
Abstract
OBJECTIVES: Forearm injuries are common and debilitating to elite rowers. Chronic exertional compartment syndrome, intersection syndrome and proximal radial bone stress injuries have been documented in this population. This paper explores the imaging findings related to these conditions in asymptomatic elite rowers. DESIGN: Observational study. METHODS: 19 asymptomatic senior elite and under-23 rowers currently competing at National level or above underwent ultrasound (US), Magnetic Resonance Imaging (MRI) and muscle functional MRI evaluation of their forearms. A comprehensive evaluation sheet identifying characteristics of bone stress, intersection syndrome and chronic exertional compartment syndrome was utilised based on a literature search and review by senior clinicians working with this population. RESULTS: Peritendinous fluid of Extensor Carpi Radialis Longus (n=10, 53%) or Extensor Carpi Radialis Brevis (n=6, 32%) was a common finding on US. MRI had a higher rate of identification than US. Extensor Digitorum (Coeff=-1.76, 95%CI -3.04 to -0.49), Flexor Carpi Radialis (Coeff=-2.86, 95%CI -5.35 to -0.38) and Flexor Carpi Ulnaris (Coeff=-3.31, 95%CI -5.30 to -1.32), Pronator Teres (Coeff=-3.94, 95%CI -6.89 to -0.99), and Supinator (Coeff=-168, 95%CI -3.28 to -0.02) showed statistically significant changes immediately post-exercise. Mild proximal radial marrow hyperintensity was present (n=15, 78.9%) with three participants (15.8%) also having mild periosteal oedema of the radius. CONCLUSIONS: Imaging findings commonly seen in symptomatic populations are observed in elite, asymptomatic rowers. Care should be taken when diagnosing bone stress injuries, intersection syndrome and compartment syndrome on imaging findings alone. Data presented can be utilised as a normative dataset for future case studies.
OBJECTIVES: Forearm injuries are common and debilitating to elite rowers. Chronic exertional compartment syndrome, intersection syndrome and proximal radial bone stress injuries have been documented in this population. This paper explores the imaging findings related to these conditions in asymptomatic elite rowers. DESIGN: Observational study. METHODS: 19 asymptomatic senior elite and under-23 rowers currently competing at National level or above underwent ultrasound (US), Magnetic Resonance Imaging (MRI) and muscle functional MRI evaluation of their forearms. A comprehensive evaluation sheet identifying characteristics of bone stress, intersection syndrome and chronic exertional compartment syndrome was utilised based on a literature search and review by senior clinicians working with this population. RESULTS: Peritendinous fluid of Extensor Carpi Radialis Longus (n=10, 53%) or Extensor Carpi Radialis Brevis (n=6, 32%) was a common finding on US. MRI had a higher rate of identification than US. Extensor Digitorum (Coeff=-1.76, 95%CI -3.04 to -0.49), Flexor Carpi Radialis (Coeff=-2.86, 95%CI -5.35 to -0.38) and Flexor Carpi Ulnaris (Coeff=-3.31, 95%CI -5.30 to -1.32), Pronator Teres (Coeff=-3.94, 95%CI -6.89 to -0.99), and Supinator (Coeff=-168, 95%CI -3.28 to -0.02) showed statistically significant changes immediately post-exercise. Mild proximal radial marrow hyperintensity was present (n=15, 78.9%) with three participants (15.8%) also having mild periosteal oedema of the radius. CONCLUSIONS: Imaging findings commonly seen in symptomatic populations are observed in elite, asymptomatic rowers. Care should be taken when diagnosing bone stress injuries, intersection syndrome and compartment syndrome on imaging findings alone. Data presented can be utilised as a normative dataset for future case studies.
Authors: Jacques Badenhorst; Mark Velleman; Audrey Jansen van Rensburg; Tanita Botha; Nikki van der Walt; Christa Janse van Rensburg Journal: SA J Radiol Date: 2021-10-06
Authors: Joshua R Lindenthaler; Anthony J Rice; Nathan G Versey; Andrew J McKune; Marijke Welvaert Journal: Front Physiol Date: 2018-07-30 Impact factor: 4.566