Return to Play in Youth Athletes: Role of the Radiologist with Focus on the Upper Extremity

Vandan Patel; Ngan P. Nguyen; Naomi Brown; Shaun D. Mendenhall; Adam C. Zoga; Jie C. Nguyen

doi:10.1055/s-0043-1778029

Seminars in Musculoskeletal Radiology, Table of Contents

Semin Musculoskelet Radiol 2024; 28(02): 180-192
DOI: 10.1055/s-0043-1778029

Review Article

Return to Play in Youth Athletes: Role of the Radiologist with Focus on the Upper Extremity

Vandan Patel

¹Department of Radiology, Section of MSK, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania

²Drexel University College of Medicine, Philadelphia, Pennsylvania

³Division of Orthopaedic Surgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania

,

Ngan P. Nguyen

¹Department of Radiology, Section of MSK, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania

²Drexel University College of Medicine, Philadelphia, Pennsylvania

,

Naomi Brown

³Division of Orthopaedic Surgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania

⁴Department of Pediatrics, Sports Medicine and Performance Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania

⁵Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania

,

Shaun D. Mendenhall

³Division of Orthopaedic Surgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania

⁵Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania

⁶Division of Plastic, Reconstructive, and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania

,

Adam C. Zoga

⁷Division of Musculoskeletal Imaging and Interventions, Department of Radiology, Thomas Jefferson University Hospital, Sidney Kimmel Medical College at Jefferson, Philadelphia, Pennsylvania

,

Jie C. Nguyen

¹Department of Radiology, Section of MSK, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania

⁵Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania

› Author Affiliations

Abstract

Increase in youth sports participation, longer duration of play, and earlier starting points have increased the prevalence of acute and repetitive overuse musculoskeletal injuries. This rise in injury rates has led to increased efforts to better understand the susceptible sites of injury that are unique to the growing immature skeleton. Upper extremity injuries are currently the best studied, particularly those that occur among pediatric baseball players and gymnasts. The weak link in skeletally immature athletes is the growth plate complex that includes those injuries located at the epiphyseal and apophyseal primary physes and the peripherally located secondary physes. This article reviews the anatomy and function of these growth plate complexes, followed by a discussion of the pathophysiologic mechanisms, spectrum of imaging findings, and existing evidence-based guidelines for injury prevention and return to play.

Keywords

apophysitis - growth plate - pediatric athlete - return to play - physeal stress injury

Full Text

References

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