Skip to main content

Advertisement

SpringerLink
Log in

Radiographic follow-up study of Little Leaguer’s shoulder

  • Scientific Article
  • Published:
Skeletal Radiology Aims and scope Submit manuscript

Abstract

Objective

Little Leaguer’s shoulder is a syndrome involving the proximal humeral epiphyseal plate. Conservative treatment usually resolves the symptoms. However, there are no reports of a radiographic follow-up study of this disease. The purpose of this study was to show the radiographic healing process of Little Leaguer’s shoulder.

Materials and methods

A total of 19 male baseball players diagnosed as having Little Leaguer’s shoulder were retrospectively evaluated. The mean age at first presentation was 12.7 years. External rotation anteroposterior radiographs of the shoulder were taken. All patients were treated with rest from throwing, and no throwing was recommended until remodeling was confirmed. Follow-up radiographs were taken at 1-month intervals to assess healing. All patients were observed until healing was confirmed radiographically, after which they returned to baseball. The mean follow-up period was 8.5 months. In addition to radiography, patients were asked whether they had any symptoms and whether they had been able to return to baseball.

Results

At the first examination, radiographs showed a wider epiphyseal plate of the throwing side compared with the asymptomatic contralateral shoulder. Healing was observed in all cases. Healing occurred first along the medial side and was then extended laterally. The mean time required for healing was 4.7 months. All patients were able to return to playing baseball at their pre-injury level of play and were asymptomatic when examined at the final follow-up.

Conclusion

The healing process of Little Leaguer’s shoulder advanced from medial to lateral, and healing was achieved about 5 months after initial examination.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Dotter WE. Little Leaguer’s shoulder. Guthrie Clin Bull. 1953;23:68.

    CAS  PubMed  Google Scholar 

  2. Drescher WR, Falliner A, Zantop T, Oehlert K, Petersen W, Hassenpflug J. Little League shoulder syndrome in an adolescent cricket player. Br J Sports Med. 2004;38:e14.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  3. Jenkinson E, Roush MB. Shoulder pain in a female volleyball player. Syllabus of the 6th American Medical Society for Sports Medicine Annual Meeting, 1996

  4. Boyd KT, Batt ME. Stress fracture of the proximal humeral epiphysis in an elite junior badminton player. Br J Sports Med. 1997;31:252–3.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  5. Adams JE. Little League shoulder: osteochondrosis of the proximal humeral epiphysis in boy baseball pitchers. Calif Med. 1966;105:22–5.

    CAS  PubMed Central  PubMed  Google Scholar 

  6. Anton C, Podberesky DJ. Little League shoulder: a growth plate injury. Pediatr Radiol. 2010;40(Suppl 1):S54.

    Article  PubMed  Google Scholar 

  7. Barnett LS. Little League shoulder syndrome: proximal humeral epiphyseolysis in adolescent baseball pitchers. A case report. J Bone Joint Surg. 1985;67A:495–6.

    Google Scholar 

  8. Carson Jr WG, Gasser SI. Little Leaguer’s shoulder. A report of 23 cases. Am J Sports Med. 1998;26:575–80.

    PubMed  Google Scholar 

  9. Taylor DC, Krasinski KL. Adolescent shoulder injuries: consensus and controversies. J Bone Joint Surg. 2009;91A:462–73.

    Google Scholar 

  10. Tullos HS, King JW. Lesions of the pitching arm in adolescents. JAMA. 1972;220:264–71.

    Article  CAS  PubMed  Google Scholar 

  11. Ireland ML, Andrews JR. Shoulder and elbow injuries in the young athlete. Clin Sports Med. 1988;7:473–94.

    CAS  PubMed  Google Scholar 

  12. Patel PR, Warner JJP. Shoulder injuries in the skeletally immature athlete. Sports Med Arthrosc Rev. 1996;4:99–113.

    Article  Google Scholar 

  13. Bright RW, Burstein AH, Elmore SM. Epiphyseal-plate cartilage: a biomechanical and histological analysis of failure modes. J Bone Joint Surg. 1974;56A:688–703.

    Google Scholar 

  14. Cahill BR, Tullos HS, Fain RH. Little League shoulder: lesions of the proximal humeral epiphyseal plate. J Sports Med. 1974;2:150–1.

    Article  CAS  PubMed  Google Scholar 

  15. Tullos HS, Fain RH. Little league shoulder: rotational stress fracture of the proximal epiphysis. J Sports Med. 1974;2:152.

    CAS  PubMed  Google Scholar 

  16. Caine D, Roy S, Singer KM, Broekhoff J. Stress changes of the distal radial growth plate. A radiographic survey and review of the literature. Am J Sports Med. 1992;20(3):290–8.

    Article  CAS  PubMed  Google Scholar 

  17. Gray H. Anatomy, descriptive and surgical, revised American edition from the 15th English edition. New York: Bounty; 1977.

    Google Scholar 

  18. Rogers LF. Radiology of skeletal trauma, vol. 1. 2nd ed. New York: Churchill Livingstone; 1992.

    Google Scholar 

  19. Kawashima A, Urakawa M, Tukanishi S, Nobuhara K. An analysis of the contour of the proximal humeral epiphyseal plate [in Japanese]. Katakansetsu. 1992;16:84–8.

    Google Scholar 

  20. Adams JE. Bone injuries in very young athletes. Clin Orthop Relat Res. 1968;58:129–40.

    Article  CAS  PubMed  Google Scholar 

  21. Tibone JE. Shoulder problems of adolescents: how they differ from those of adults. Clin Sports Med. 1983;2:423–7.

    CAS  PubMed  Google Scholar 

  22. Torg JS, Pollack H, Sweterlitsch P. The effect of competitive pitching on the shoulders and elbows of preadolescent baseball players. Pediatrics. 1972;49:267–72.

    CAS  PubMed  Google Scholar 

  23. Fleming JL, Hollingsworth CL, Squire DL, et al. Little Leaguer’s shoulder. Skeletal Radiol. 2004;33:352–4.

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Tokushima National Hospital, Tokushima, Japan

    Yoshiji Kanematsu & Takenobu Iwase

  2. Department of Orthopedics, Institute of Health Bioscience, University of Tokushima Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan

    Tetsuya Matsuura, Naoto Suzue & Koichi Sairyo

  3. Department of Orthopaedic Surgery, Japan Community Health Care Organization, Tokyo Shinjuku Medical Center, Tokyo, Japan

    Shinji Kashiwaguchi

  4. Department of Orthopaedic Surgery, Tokushima Prefectural Central Hospital, Tokushima, Japan

    Toshiyuki Iwame

Authors
  1. Yoshiji Kanematsu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tetsuya Matsuura
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shinji Kashiwaguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Takenobu Iwase
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Naoto Suzue
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Toshiyuki Iwame
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Koichi Sairyo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tetsuya Matsuura.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kanematsu, Y., Matsuura, T., Kashiwaguchi, S. et al. Radiographic follow-up study of Little Leaguer’s shoulder. Skeletal Radiol 44, 73–76 (2015). https://doi.org/10.1007/s00256-014-2007-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00256-014-2007-2

Keywords

Search

Navigation