MRI does not effectively diagnose ulnar-sided wrist pain in elite tennis players |
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| Institution: | 1. Tennis Australia, Australia;2. Victoria House Imaging, Australia;3. University of Western Australia, Australia;4. Melbourne Orthopaedic Group, Monash University, Department of Surgery, Australia;5. Institute of Exercise, Sport and Active Living, Victoria University, Australia;1. Department of Sports Medicine, Sports Surgery Clinic, Ireland;2. Department for Health, University of Bath, United Kingdom;3. Insight Centre for Data Analytics, Dublin City University, Ireland;1. Public Health Evaluation and Projection Unit, The Finnish Institute for Health and Welfare, Finland;2. Department of Health Promoting Science, Sophiahemmet University, Sweden;3. Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Sweden;4. Public Health Promotion Unit, The Finnish Institute for Health and Welfare, Finland;5. Institute of Public Health, University of Eastern Finland (UEF), Finland;6. Joint Municipal Authority for North Karelia Social and Health Services (Siun sote), Finland;7. Department of Social Sciences, University of Eastern Finland (UEF), Finland;8. Ageing, Disability and Functioning Unit, The Finnish Institute for Health and Welfare, Finland;9. Age Institute, Finland;1. Deakin University, Institute for Physical Activity & Nutrition Research (IPAN), School of Exercise and Nutrition Sciences, Australia;2. Mary MacKillop Institute for Health Research, Australian Catholic University, Australia;1. School of Allied Health/Pharmacy, University of Western Australia, Australia;2. Western Australian Institute of Sport, Australia;3. School of Human Sciences (Exercise and Sport Science), University of Western Australia, Australia;1. Department of Exercise Science, High Point University, High Point, NC, USA;2. Department of Physician Assistant Studies, High Point, NC, USA;3. Department of Anthropology, The University of Iowa, Iowa City, IA, USA;4. Department of Sociology and Anthropology, Metropolitan State University of Denver, CO, USA;5. Department of Biological Sciences, Bronx Community College, City University of New York, Bronx, NY, USA;6. Department of Anthropology, University of Arkansas, Fayetteville, AR, USA |
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| Abstract: | ObjectivesUlnar-sided injuries of the non-dominant wrist are common in elite tennis players using a double-handed backhand technique. This study investigated the radiological changes of the non-dominant wrist in elite symptomatic and asymptomatic players using this technique as well as healthy controls. We compared clinical findings to radiological abnormalities.DesignCross-sectional design with blinded radiological assessment, and contemporaneous clinical assessment of symptomatic players.MethodsMagnetic resonance images (MRI) of wrists related to non-dominant ulnar-sided pain, were taken in 14 symptomatic tennis players, 14 asymptomatic tennis players, and 12 healthy controls which were then independently reviewed for abnormalities by blinded radiologists. Total abnormalities and global between-group differences in the triangular fibrocartilage complex (TFC), ulnar collateral ligament (UCL), extensor carpi ulnaris (ECU) and supporting structures, osseous-articular lesions and ganglia were assessed. These were then compared to clinical examinations of the symptomatic players to assess agreement.ResultsSymptomatic players reported a mean 3.64 abnormalities, being exactly 1 abnormality greater than asymptomatic players (2.64) and controls (2.50), suggesting similar asymptomatic lesions in all three groups. Players with pain reported significantly more osseous-articular lesions, ECU tendon and dorsal radio-ulnar ligament abnormalities, while changes to the UCL may reflect an isolated problem in specific wrists. There were no between-group differences in the presence of ganglia, most TFC structures nor ECU subsheath tear and subluxation.ConclusionsClinicians should carefully consider radiological changes alongside their clinical diagnosis of non-dominant wrist pain in tennis players due to possible tennis-related changes and/or asymptomatic findings. |
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| Keywords: | Imaging Professional athletes Injury Technique |
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