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CC BY 4.0 · Journal of Child Science 2021; 11(01): e240-e244
DOI: 10.1055/s-0041-1735535
Original Article

Investigation of Ultrasound as a Diagnostic Imaging Modality for Little League Shoulder

Shayne Fehr
1   Department of Orthopaedic Surgery, Children's Wisconsin; Medical College of Wisconsin, Milwaukee, Wisconsin, United States
,
Gunnar Whealy
1   Department of Orthopaedic Surgery, Children's Wisconsin; Medical College of Wisconsin, Milwaukee, Wisconsin, United States
,
Xue-Cheng Liu 
1   Department of Orthopaedic Surgery, Children's Wisconsin; Medical College of Wisconsin, Milwaukee, Wisconsin, United States
› Author Affiliations Funding None.
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Abstract

Objective Ultrasound (US) is an established imaging modality in adult sports medicine but is not commonly used in the diagnosis of pediatric sports conditions, such as Little League shoulder (LLS). This study was conducted to determine the reliability of US measurement of width of the physis at the proximal humerus in diagnosed LLS and to compare US to radiography (RA) in detecting a difference between the affected (dominant) (A) and unaffected (U) shoulders.

Materials and Methods Ten male baseball players diagnosed with LLS were enrolled in the study. US images of the proximal humeral physis at the greater tuberosity of both shoulders were obtained by an US-trained sports medicine physician, and the physeal width was measured. Blinded to prior measurements, a separate physician performed measurements on the stored US images. Measurements were compared with RA on the anteroposterior (AP) view for both A and U at the time of the initial visit and for A at follow-up.

Results The physeal width (mm) at A and U at the initial visit averaged 5.94 ± 1.69 and 4.36 ± 1.20 respectively on RA, and 4.15 ± 1.12 and 3.40 ± 0.85 on US. Median difference of averaged US measurements between A and U at initial evaluation was 0.75 mm (p = 0.00016). A linear model showed US measurements to be predictive of RA on A (R2 = 0.51) and U (R2 = 0.48).

Conclusion US was able to reliably measure the width of the proximal humeral physis and detect a difference between A and U. US correlated well with RA (standard for LLS). US should be considered by the US-trained physician for the diagnosis of LLS.

Keywords

pediatric sports medicine - little league shoulder - proximal physeal epiphysiolysis - musculoskeletal ultrasound


Publication History

Received: 14 December 2020

Accepted: 25 July 2021

Article published online:
28 September 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Georg Thieme Verlag KG
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