Ching Chung Ko1, Ming Hong Tai2, Chien Hung Lin3, Wen Sheng Tzeng4, Jeon Hor Chen5, Ginger Shu6, Chung Da Wu7, Clement Kuen Huang Chen8. 1. Department of Medical Imaging, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang District, Tainan City 71004, Taiwan; Institute of Biomedical Science, National Sun Yat-Sen University, Kaohsiung, Taiwan. Electronic address: crazyboy0729@gmail.com. 2. Institute of Biomedical Science, National Sun Yat-Sen University, Kaohsiung, Taiwan. Electronic address: mhtai@faculty.nsysu.edu.tw. 3. Department of Medical Imaging, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang District, Tainan City 71004, Taiwan. Electronic address: chienhark@yahoo.com.tw. 4. Department of Medical Imaging, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang District, Tainan City 71004, Taiwan. Electronic address: tws4664@gmail.com. 5. Department of Radiology, I-Shou University and Eda Hospital, No. 1, Yi-Da Road, Jiau-Shu Tsuen, Yan-Chau Shiang, Kaohsiung County 824, Taiwan. Electronic address: jeonhc@uci.edu. 6. Department of Medical Imaging, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang District, Tainan City 71004, Taiwan. Electronic address: mariposa@seed.net.tw. 7. Department of Orthopaedics, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang District, Tainan City 71004, Taiwan. Electronic address: wcd@mail.chimei.org.tw. 8. Department of Medical Imaging, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang District, Tainan City 71004, Taiwan. Electronic address: ckhc821@gmail.com.
Abstract
PURPOSE: Posteromedial olecranon impingement (PMOI) is the most common diagnosis in baseball players with throwing-induced elbow injuries. CT imaging manifestations of PMOI have seldom been previously reported. Our purpose is to investigate the additional value of CT imaging in the evaluation of PMOI. MATERIALS AND METHODS: From July 2010 to December 2013, 47 baseball players with throwing-induced elbow pain received imaging studies (CT and/or MRI) of the elbow at our institution. After retrospectively reviewing the clinical records and imaging studies, 31 of the 47 players were diagnosed with PMOI by the criteria of posteromedial elbow pain with clinical consistency for PMOI and characteristic osteoarthrosis at the posteromedial ulnotrochlear articulation (posteromedial olecranon space, PMOS) detected by CT and/or MRI. The imaging modalities of these 31 players including radiography, CT, and MRI were reviewed by 2 experienced musculoskeletal radiologists. RESULTS: The most common imaging manifestations of PMOI by CT or MRI include joint space narrowing, subchondral sclerosis, and osteophytes at the PMOS. CT was superior to MRI with a statistically significant (P<0.05) difference in detecting joint space narrowing, medial olecranon subluxation, as well as the number of loose bodies. In contrast, bone marrow edema and associated soft tissue injuries in PMOI are more readily observed on MRI. CONCLUSIONS: CT is superior in identifying some imaging features of PMOI. Whenever PMOI is diagnosed in the pitching elbow of a baseball player, CT should be considered prior to surgical intervention as it will often provide additional information to the surgeon that may alter surgical management.
PURPOSE: Posteromedial olecranon impingement (PMOI) is the most common diagnosis in baseball players with throwing-induced elbow injuries. CT imaging manifestations of PMOI have seldom been previously reported. Our purpose is to investigate the additional value of CT imaging in the evaluation of PMOI. MATERIALS AND METHODS: From July 2010 to December 2013, 47 baseball players with throwing-induced elbow pain received imaging studies (CT and/or MRI) of the elbow at our institution. After retrospectively reviewing the clinical records and imaging studies, 31 of the 47 players were diagnosed with PMOI by the criteria of posteromedial elbow pain with clinical consistency for PMOI and characteristic osteoarthrosis at the posteromedial ulnotrochlear articulation (posteromedial olecranon space, PMOS) detected by CT and/or MRI. The imaging modalities of these 31 players including radiography, CT, and MRI were reviewed by 2 experienced musculoskeletal radiologists. RESULTS: The most common imaging manifestations of PMOI by CT or MRI include joint space narrowing, subchondral sclerosis, and osteophytes at the PMOS. CT was superior to MRI with a statistically significant (P<0.05) difference in detecting joint space narrowing, medial olecranon subluxation, as well as the number of loose bodies. In contrast, bone marrow edema and associated soft tissue injuries in PMOI are more readily observed on MRI. CONCLUSIONS: CT is superior in identifying some imaging features of PMOI. Whenever PMOI is diagnosed in the pitching elbow of a baseball player, CT should be considered prior to surgical intervention as it will often provide additional information to the surgeon that may alter surgical management.
Authors: Elisabetta Antonia Nocerino; Davide Cucchi; Paolo Arrigoni; Marco Brioschi; Cristiano Fusi; Eugenio A Genovese; Carmelo Messina; Pietro Randelli; Carlo Masciocchi; Alberto Aliprandi Journal: Acta Biomed Date: 2018-01-19