Abstract
Objective
Elbow screening of adolescent baseball players began in 2014 using ultrasound, palpation, and dedicated magnetic resonance imaging (MRI). We frequently encountered subjects showing MCL injury on MRI but no clinical symptoms. We assessed variations in asymptomatic MCL injury findings at follow-up MRI, and clarified the pathogenesis of these findings.
Materials and methods
Using a 0.2-T-dedicated MRI, 30 subjects with asymptomatic MCL injury at initial MRI who agreed to follow-up MRI were included. We classified the findings at repeat MRI as follows: (a) disappeared, (b) better, and (c) worse.
Results
There were 6, 16, and 8 subjects in groups a, b, and c, respectively. The average age at follow-up was 14.0, 12.1, and 12.4 years in groups a, b, and c, respectively. There were significant differences between groups a and b and between groups a and c. Average height at follow-up of groups a, b, and c was 1.64, 1.52, and 1.57 cm, respectively, with a statistically significant difference between groups a and b. The average size of the short axis of the MCL of subjects in group a was 2.0 cm on the dominant side and 1.5 cm on the contradominant side (P < 0.04).
Conclusion
Players with asymptomatic MCL injury can continue to play baseball with no limitations, as these findings usually disappear around the age of 14.0 years, when the growth spurt occurs. This finding may be a precursor of ‘adaptation’, which is generally observed in high school baseball players, suggesting that the MCL adapts as growth occurs.
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Acknowledgements
I would like to express my greatest appreciation to Akito Kawasaki and Masashi Maruyama for their useful discussion and ideas regarding this work.
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Makihara, T., Okamoto, Y., Yoshizawa, T. et al. Change in MRI findings of medial collateral ligament injury in adolescent baseball players with no clinical symptoms over time. Skeletal Radiol 48, 1925–1932 (2019). https://doi.org/10.1007/s00256-019-03231-y
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DOI: https://doi.org/10.1007/s00256-019-03231-y