Upper Extremity Injuries in Young Athletes

Abstract

Injuries are becoming increasingly prevalent in pediatric athletes. Many of these injuries are diagnosed clinically and do not require imaging for diagnosis, but the sheer increase in numbers of injuries means that radiologists are evaluating more of them. Some injuries that young athletes sustain are simply due to trauma, such as falls, and may be experienced outside sports just as easily; however, others are peculiar to athletic activities. Many of the latter are chronic overuse injuries as opposed to acute injuries and have characteristic appearances. The types of injuries young athletes incur often change based on the stage of skeletal maturity of the patient, and it serves the radiologist well to keep in mind the typical appearances expected at different ages.

Keywords

pediatric - sports - injuries - shoulder - elbow - wrist

• References

• 1 Monroe KW, Thrash C, Sorrentino A, King WD. Most common sports-related injuries in a pediatric emergency department. Clin Pediatr (Phila) 2011; 50 (1) 17-20
• 2 Carter CW, Micheli LJ. Training the child athlete for prevention, health promotion, and performance: how much is enough, how much is too much?. Clin Sports Med 2011; 30 (4) 679-690
• 3 2010–2011 High School Athletics Participation Survey. 2012 [April 10, 2012]; Available at: http://www.nfhs.org/content.aspx?id=3282
• 4 Safe Kids USA. 2011 [April 10, 2012]; Available at: http://www.safekids.org/assets/docs/ourwork/research/2011-sports-fact-sheet.pdf
• 5 Outerbridge AR, Micheli LJ. Overuse injuries in the young athlete. Clin Sports Med 1995; 14 (3) 503-516
• 6 Micheli LJ, Klein JD. Sports injuries in children and adolescents. Br J Sports Med 1991; 25 (1) 6-9
• 7 Brenner JS ; American Academy of Pediatrics Council on Sports Medicine and Fitness. Overuse injuries, overtraining, and burnout in child and adolescent athletes. Pediatrics 2007; 119 (6) 1242-1245
• 8 Soprano JV. Musculoskeletal injuries in the pediatric and adolescent athlete. Curr Sports Med Rep 2005; 4 (6) 329-334
• 9 Luke A, Lazaro RM, Bergeron MF , et al. Sports-related injuries in youth athletes: is overscheduling a risk factor?. Clin J Sport Med 2011; 21 (4) 307-314
• 10 Hill DE, Andrews JR. Stopping sports injuries in young athletes. Clin Sports Med 2011; 30 (4) 841-849
• 11 Taylor BL, Attia MW. Sports-related injuries in children. Acad Emerg Med 2000; 7 (12) 1376-1382
• 12 Damore DT, Metzl JD, Ramundo M, Pan S, Van Amerongen R. Patterns in childhood sports injury. Pediatr Emerg Care 2003; 19 (2) 65-67
• 13 Swenson DM, Yard EE, Collins CL, Fields SK, Comstock RD. Epidemiology of US high school sports-related fractures, 2005–2009. Clin J Sport Med 2010; 20 (4) 293-299
• 14 Chen FS, Diaz VA, Loebenberg M, Rosen JE. Shoulder and elbow injuries in the skeletally immature athlete. J Am Acad Orthop Surg 2005; 13 (3) 172-185
• 15 Protecting Young Pitching Arms. 2008 [April 10, 2012]; Available at: http://www.littleleague.org/assets/old_assets/media/pitch_count_publication_2008.pdf
• 16 Adams JE. Little league shoulder: osteochondrosis of the proximal humeral epiphysis in boy baseball pitchers. Calif Med 1966; 105 (1) 22-25
• 17 Taylor DC, Krasinski KL. Adolescent shoulder injuries: consensus and controversies. Instr Course Lect 2009; 58: 281-292
• 18 Wasserlauf BL, Paletta Jr GA. Shoulder disorders in the skeletally immature throwing athlete. Orthop Clin North Am 2003; 34 (3) 427-437
• 19 Lyman S, Fleisig GS, Andrews JR, Osinski ED. Effect of pitch type, pitch count, and pitching mechanics on risk of elbow and shoulder pain in youth baseball pitchers. Am J Sports Med 2002; 30 (4) 463-468
• 20 Kelly AM, Pappas AM. Shoulder and elbow injuries and painful syndromes. Adolesc Med 1998; 9 (3) 569-587, vii
• 21 Jaramillo D, Hoffer FA, Shapiro F, Rand F. MR imaging of fractures of the growth plate. AJR Am J Roentgenol 1990; 155 (6) 1261-1265
• 22 Marshall KW, Marshall DL, Busch MT. Shoulder pain in the adolescent athlete: a multidisciplinary diagnostic approach from the medical, surgical, and imaging perspectives. Pediatr Radiol 2010; 40 (4) 453-460
• 23 Sciascia A, Kibler WB. The pediatric overhead athlete: what is the real problem?. Clin J Sport Med 2006; 16 (6) 471-477
• 24 Marans HJ, Angel KR, Schemitsch EH, Wedge JH. The fate of traumatic anterior dislocation of the shoulder in children. J Bone Joint Surg Am 1992; 74 (8) 1242-1244
• 25 Deitch J, Mehlman CT, Foad SL, Obbehat A, Mallory M. Traumatic anterior shoulder dislocation in adolescents. Am J Sports Med 2003; 31 (5) 758-763
• 26 Podberesky DJ, Unsell BJ, Anton CG. Imaging of American football injuries in children. Pediatr Radiol 2009; 39 (12) 1264-1274; quiz 1385–1386
• 27 Escobedo EM, Richardson ML, Schulz YB, Hunter JC, Green III JR, Messick KJ. Increased risk of posterior glenoid labrum tears in football players. AJR Am J Roentgenol 2007; 188 (1) 193-197
• 28 Itoi E, Tabata S. Rotator cuff tears in the adolescent. Orthopedics 1993; 16 (1) 78-81
• 29 Kleposki RW, Wells L, Wilson M, Sehgal K. Rotator cuff injuries in skeletally immature patients: prevention and indications for the orthopaedic nurse. Orthop Nurs 2009; 28 (3) 134-138, quiz 139–140
• 30 Park HB, Lin SK, Yokota A, McFarland EG. Return to play for rotator cuff injuries and superior labrum anterior posterior (SLAP) lesions. Clin Sports Med 2004; 23 (3) 321-334, vii
• 31 Emery KH. MR imaging in congenital and acquired disorders of the pediatric upper extremity. Magn Reson Imaging Clin N Am 2009; 17 (3) 549-570, vii
• 32 Mariscalco MW, Saluan P. Upper extremity injuries in the adolescent athlete. Sports Med Arthrosc 2011; 19 (1) 17-26
• 33 Kocher MS, Waters PM, Micheli LJ. Upper extremity injuries in the paediatric athlete. Sports Med 2000; 30 (2) 117-135
• 34 DiPaola M, Marchetto P. Coracoid process fracture with acromioclavicular joint separation in an American football player: a case report and literature review. Am J Orthop 2009; 38 (1) 37-39; discussion 40
• 35 Long G, Cooper JR, Gibbon WW. Magnetic resonance imaging of injuries in the child athlete. Clin Radiol 1999; 54 (12) 781-791
• 36 King JB. Post-traumatic ectopic calcification in the muscles of athletes: a review. Br J Sports Med 1998; 32 (4) 287-290
• 37 McCarthy EF, Sundaram M. Heterotopic ossification: a review. Skeletal Radiol 2005; 34 (10) 609-619
• 38 Kijowski R, Tuite MJ. Pediatric throwing injuries of the elbow. Semin Musculoskelet Radiol 2010; 14 (4) 419-429
• 39 Greiwe RM, Saifi C, Ahmad CS. Pediatric sports elbow injuries. Clin Sports Med 2010; 29 (4) 677-703
• 40 Rudzki JR, Paletta Jr GA. Juvenile and adolescent elbow injuries in sports. Clin Sports Med 2004; 23 (4) 581-608, ix
• 41 Brogdon BG, Crow NE. Little leaguer's elbow. Am J Roentgenol Radium Ther Nucl Med 1960; 83: 671-675
• 42 Sugimoto H, Ohsawa T. Ulnar collateral ligament in the growing elbow: MR imaging of normal development and throwing injuries. Radiology 1994; 192 (2) 417-422
• 43 Bauer M, Jonsson K, Josefsson PO, Lindén B. Osteochondritis dissecans of the elbow. A long-term follow-up study. Clin Orthop Relat Res 1992; (284) 156-160
• 44 Kijowski R, De Smet AA. Radiography of the elbow for evaluation of patients with osteochondritis dissecans of the capitellum. Skeletal Radiol 2005; 34 (5) 266-271
• 45 Do T, Herrera-Soto J. Elbow injuries in children. Curr Opin Pediatr 2003; 15 (1) 68-73
• 46 Niemeyer P, Weinberg A, Schmitt H, Kreuz PC, Ewerbeck V, Kasten P. Stress fractures in the juvenile skeletal system. Int J Sports Med 2006; 27 (3) 242-249
• 47 John SD, Wherry K, Swischuk LE, Phillips WA. Improving detection of pediatric elbow fractures by understanding their mechanics. Radiographics 1996; 16 (6) 1443-1460; quiz 1463–1464
• 48 DiFiori JP, Puffer JC, Mandelbaum BR, Dorey F. Distal radial growth plate injury and positive ulnar variance in nonelite gymnasts. Am J Sports Med 1997; 25 (6) 763-768
• 49 Zetaruk MN. The young gymnast. Clin Sports Med 2000; 19 (4) 757-780
• 50 Terry CL, Waters PM. Triangular fibrocartilage injuries in pediatric and adolescent patients. J Hand Surg Am 1998; 23 (4) 626-634
• 51 Alt V, Gasnier J, Sicre G. Injuries of the scapholunate ligament in children. J Pediatr Orthop B 2004; 13 (5) 326-329
• 52 Kaawach W, Ecklund K, Di Canzio J, Zurakowski D, Waters PM. Normal ranges of scapholunate distance in children 6 to 14 years old. J Pediatr Orthop 2001; 21 (4) 464-467
• 53 Rettig AC. Athletic injuries of the wrist and hand. Part I: traumatic injuries of the wrist. Am J Sports Med 2003; 31 (6) 1038-1048
• 54 Cook PA, Yu JS, Wiand W, Cook II AJ, Coleman CR, Cook AJ. Suspected scaphoid fractures in skeletally immature patients: application of MRI. J Comput Assist Tomogr 1997; 21 (4) 511-515
• 55 Gaca AM. Basketball injuries in children. Pediatr Radiol 2009; 39 (12) 1275-1285
• 56 Rettig AC. Athletic injuries of the wrist and hand: part II: overuse injuries of the wrist and traumatic injuries to the hand. Am J Sports Med 2004; 32 (1) 262-273