Sidney M Levy1,2, Machar Reid3,4, Anne-Marie Montgomery3, Elissa Botterill5, Stephanie A Kovalchik3,6, Melanie Omizzolo3, Frank Malara5, Timothy O Wood3, Gregory A Hoy7,8, Andrew H Rotstein5. 1. Victoria House Medical Imaging, I-MED Radiology Network, Melbourne, Victoria, Australia. sidney.levy@i-med.com.au. 2. Department of Diagnostic Imaging, Monash Health, Melbourne, Victoria, Australia. sidney.levy@i-med.com.au. 3. Tennis Australia, Melbourne, Victoria, Australia. 4. University of Western Australia, Perth, Western Australia, Australia. 5. Victoria House Medical Imaging, I-MED Radiology Network, Melbourne, Victoria, Australia. 6. Institute of Exercise, Sport and Active Living, Victoria University, Melbourne, Victoria, Australia. 7. Melbourne Orthopaedic Group, Melbourne, Victoria, Australia. 8. Department of Surgery, Monash University, Melbourne, Victoria, Australia.
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.
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.
Authors: Danielle T Gescheit; Stuart J Cormack; Rob Duffield; Stephanie Kovalchik; Tim O Wood; Melanie Omizzolo; Machar Reid Journal: Br J Sports Med Date: 2017-07-07 Impact factor: 13.800
Authors: Atsuya Watanabe; Felipe Souza; Peter S Vezeridis; Philip Blazar; Hiroshi Yoshioka Journal: Skeletal Radiol Date: 2009-12-10 Impact factor: 2.199