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- Title
Progressive Elbow Magnetic Resonance Imaging Abnormalities in Little League Baseball Players Are Common: A 3-Year Longitudinal Evaluation.
- Authors
Holt, Joshua B.; Pedowitz, Jason M.; Stearns, Philip H.; Bastrom, Tracey P.; Dennis, M. Morgan; Dwek, Jerry R.; Pennock, Andrew T.
- Abstract
Background: Prior studies have revealed magnetic resonance imaging (MRI) evidence of elbow pathology in single-season evaluation of competitive youth baseball players. The natural history of these findings and risk factors for progression have not been reported. Purpose: To characterize the natural history of bilateral elbow MRI findings in a 3-year longitudinal study and to correlate abnormalities with prior MRI findings, throwing history, playing status, and physical examination. Study Design: Cohort study; Level of evidence, 2. Methods: A prospective study of Little League players aged 12 to 15 years was performed. All players had preseason and postseason bilateral elbow MRI performed 3 years before this study. Players underwent repeat bilateral elbow MRI, physical examination, and detailed assessment of throwing history, playing status, and arm pain. Imaging was read by a blinded musculoskeletal radiologist and compared with prior MR images to assess for progression or resolution of previously identified pathology. Results: All 26 players who participated in the previous single-season study returned for a 3-year assessment. At the completion of the study, 15 players (58%) had dominant arm MRI pathology. Eighty percent (12/15 players) of MRI findings were new or progressive lesions. Players with postseason MRI pathology at the beginning of the study were more likely to have MRI pathology at the 3-year follow-up than players with previously normal postseason MRI (P <.05), although 6 of the 14 players (43%) with previously normal MRI developed new pathology. Year-round play was a significant predictor of tenderness to elbow palpation (P =.027) and positive MRI findings at 3 years (P =.047). At the 3-year follow-up, 7 players (27%) reported having throwing elbow pain and 3 had required casting. Additionally, differences were noted in the dominant arm's internal and external rotation in those that continued to play baseball (P <.05). Conclusion: Dominant elbow MRI abnormalities are common in competitive Little League Baseball players. Year-round play imparts significant risk for progression of MRI pathology and physical examination abnormalities.
- Subjects
ANALYSIS of variance; ARM; ATHLETES; BASEBALL; COMPARATIVE studies; STATISTICAL correlation; ELBOW; LONGITUDINAL method; MAGNETIC resonance imaging; MEDICAL history taking; PAIN; PEDIATRICS; PHYSICAL diagnosis; SURGICAL plaster casts; SPORTS medicine; STATISTICS; DATA analysis; MULTIPLE regression analysis; QUANTITATIVE research; SPORTS participation; THROWING (Sports); REPEATED measures design; DATA analysis software; DESCRIPTIVE statistics; ODDS ratio
- Publication
American Journal of Sports Medicine, 2020, Vol 48, Issue 2, p466
- ISSN
0363-5465
- Publication type
Article
- DOI
10.1177/0363546519888647