Taku Hatta1, Nobuyuki Yamamoto2, Hirotaka Sano2, Hideaki Nagamoto2, Daisuke Kurokawa2, Hiroyuki Takahashi2, Minoru Tanaka3, Yoichi Koike4, Eiji Itoi2. 1. Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan. hat@ortho.med.tohoku.ac.jp. 2. Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan. 3. Department of Orthopaedic Surgery, Tohoku Rosai Hospital, Sendai, Japan. 4. Department of Orthopaedic Surgery, Sendai Red Cross Hospital, Sendai, Japan.
Abstract
PURPOSE: The purpose of this study was to investigate the association between acromioclavicular (AC) joint pain and superior capsular bulging assessed by ultrasound in adolescent baseball players. METHODS: One hundred and fifty players (1st-8th graders) were examined. All subjects underwent physical examinations, including assessment of tenderness on the AC joint and provocative tests (the Buchberger's test and the cross-body adduction stress test). Bilateral AC joints with the arm in both the resting and the cross-body positions were examined by ultrasound. RESULTS: Twelve of 150 players (8 %) had AC symptoms with both positive tenderness and positive provocative tests. Interestingly, their prevalence increased with age-one of the 70 (1.4 %) 1st-3rd graders, six of 46 (13 %) 4th-6th graders and five of 34 (15 %) 7th-8th graders. Ultrasonography of AC joints in the cross-body position showed that the difference in superior capsular bulging between the throwing and non-throwing sides was significantly greater in symptomatic players (1.6 ± 1.2 mm) than in asymptomatic players (0.2 ± 0.8 mm) (p = 0.002). CONCLUSION: The prevalence of superior capsular bulging was significantly higher in adolescent baseball players with AC joint pain than in those without it. In adolescent baseball players with shoulder pain, AC joint symptoms should be considered amongst potential causes. Careful observation of these patients is suggested in cases of superior capsular bulging of the AC joint as determined by ultrasonography. LEVEL OF EVIDENCE: III.
PURPOSE: The purpose of this study was to investigate the association between acromioclavicular (AC) joint pain and superior capsular bulging assessed by ultrasound in adolescent baseball players. METHODS: One hundred and fifty players (1st-8th graders) were examined. All subjects underwent physical examinations, including assessment of tenderness on the AC joint and provocative tests (the Buchberger's test and the cross-body adduction stress test). Bilateral AC joints with the arm in both the resting and the cross-body positions were examined by ultrasound. RESULTS: Twelve of 150 players (8 %) had AC symptoms with both positive tenderness and positive provocative tests. Interestingly, their prevalence increased with age-one of the 70 (1.4 %) 1st-3rd graders, six of 46 (13 %) 4th-6th graders and five of 34 (15 %) 7th-8th graders. Ultrasonography of AC joints in the cross-body position showed that the difference in superior capsular bulging between the throwing and non-throwing sides was significantly greater in symptomatic players (1.6 ± 1.2 mm) than in asymptomatic players (0.2 ± 0.8 mm) (p = 0.002). CONCLUSION: The prevalence of superior capsular bulging was significantly higher in adolescent baseball players with AC joint pain than in those without it. In adolescent baseball players with shoulder pain, AC joint symptoms should be considered amongst potential causes. Careful observation of these patients is suggested in cases of superior capsular bulging of the AC joint as determined by ultrasonography. LEVEL OF EVIDENCE: III.
Authors: J T Davis; Orr Limpisvasti; Derrick Fluhme; Karen J Mohr; Lewis A Yocum; Neal S Elattrache; Frank W Jobe Journal: Am J Sports Med Date: 2009-08 Impact factor: 6.202
Authors: Judie Walton; Sanjeev Mahajan; Anastasios Paxinos; Jeanette Marshall; Carl Bryant; Ron Shnier; Richard Quinn; George A C Murrell Journal: J Bone Joint Surg Am Date: 2004-04 Impact factor: 5.284