Skip to main content
Top
Published in: Skeletal Radiology 7/2019

01-07-2019 | Magnetic Resonance Imaging | Scientific Article

Characterization of glenoid bone remodeling in professional baseball pitchers

Authors: Jonathan Rassi, Naveen Subhas, Jennifer Bullen, Michael Forney, Joshua Polster

Published in: Skeletal Radiology | Issue 7/2019

Login to get access

Abstract

Objective

To characterize the appearance, location, severity, and prevalence of focal glenoid retroversion on shoulder MRI in professional baseball pitchers versus age-matched controls.

Materials and methods

In this retrospective review, two musculoskeletal radiologists evaluated shoulder MRI examinations from 40 professional baseball pitchers and 40 age-matched controls. Images were scored for the presence of a focal posterior glenoid convexity and the clock face positions involved. A consensus interpretation was also performed. A third reader identified the presence of additional shoulder abnormalities.

Results

After consensus, 60% (24/40) of pitchers were found to have focal glenoid retroversion versus 20% (8/40) of controls (p = 0.001). The most apparent location was posterior or posterior-superior, from 7.75 o’clock to 10.5 o’clock (median, 9.75 o’clock; interquartile range, 9.25–10 o’clock). The median clock angle of involvement was greater in pitchers than in controls (30° vs. 0°; p < 0.001). Interreader agreement regarding the presence or absence of focal glenoid retroversion was moderate (Cohen’s kappa, 0.49). Focal glenoid retroversion was more prevalent among subjects with additional shoulder abnormalities (p = 0.014).

Conclusions

Glenoid remodeling occurs in the throwing shoulder of professional baseball pitchers and manifests as focally convex morphology of the posterior or posterior-superior glenoid. This type of remodeling does not appear to be associated with a lower prevalence of injuries related to posterior-superior impingement.
Literature
1.
go back to reference Sabick MB, Kim YK, Torry MR, Keirns MA, Hawkins RJ. Biomechanics of the shoulder in youth baseball pitchers: implications for the development of proximal humeral epiphysiolysis and humeral retrotorsion. Am J Sports Med. 2005;33:1716–22.CrossRefPubMed Sabick MB, Kim YK, Torry MR, Keirns MA, Hawkins RJ. Biomechanics of the shoulder in youth baseball pitchers: implications for the development of proximal humeral epiphysiolysis and humeral retrotorsion. Am J Sports Med. 2005;33:1716–22.CrossRefPubMed
2.
go back to reference Warden SJ, Bogenschutz ED, Smith HD, Gutierrez AR. Throwing induces substantial torsional adaptation within the midshaft humerus of male baseball players. Bone. 2009;45:931–41.CrossRefPubMed Warden SJ, Bogenschutz ED, Smith HD, Gutierrez AR. Throwing induces substantial torsional adaptation within the midshaft humerus of male baseball players. Bone. 2009;45:931–41.CrossRefPubMed
3.
go back to reference Polster JM, Bullen J, Obuchowski NA, Bryan JA, Soloff L, Schickendantz MS. Relationship between humeral torsion and injury in professional baseball pitchers. Am J Sports Med. 2013;41:2015–21.CrossRefPubMed Polster JM, Bullen J, Obuchowski NA, Bryan JA, Soloff L, Schickendantz MS. Relationship between humeral torsion and injury in professional baseball pitchers. Am J Sports Med. 2013;41:2015–21.CrossRefPubMed
4.
go back to reference Crockett HC, Gross LB, Wilk KE, et al. Osseous adaptation and range of motion at the glenohumeral joint in professional baseball pitchers. Am J Sports Med. 2002;30:20–6.CrossRefPubMed Crockett HC, Gross LB, Wilk KE, et al. Osseous adaptation and range of motion at the glenohumeral joint in professional baseball pitchers. Am J Sports Med. 2002;30:20–6.CrossRefPubMed
5.
go back to reference Drakos MC, Barker JU, Osbahr DC, et al. Effective glenoid version in professional baseball players. Am J Orthop (Belle Mead NJ). 2010;39:340–4. Drakos MC, Barker JU, Osbahr DC, et al. Effective glenoid version in professional baseball players. Am J Orthop (Belle Mead NJ). 2010;39:340–4.
6.
go back to reference Wyland DJ, Pill SG, Shanley E, et al. Bony adaptation of the proximal humerus and glenoid correlate within the throwing shoulder of professional baseball pitchers. Am J Sports Med. 2012;40:1858–62.CrossRefPubMed Wyland DJ, Pill SG, Shanley E, et al. Bony adaptation of the proximal humerus and glenoid correlate within the throwing shoulder of professional baseball pitchers. Am J Sports Med. 2012;40:1858–62.CrossRefPubMed
7.
go back to reference Chang IY, Polster JM. Pathomechanics and magnetic resonance imaging of the thrower's shoulder. Radiol Clin N Am. 2016;54:801–15.CrossRefPubMed Chang IY, Polster JM. Pathomechanics and magnetic resonance imaging of the thrower's shoulder. Radiol Clin N Am. 2016;54:801–15.CrossRefPubMed
8.
go back to reference Shimizu T, Iwasaki N, Nishida K, Minami A, Funakoshi T. Glenoid stress distribution in baseball players using computed tomography osteoabsorptiometry: a pilot study. Clin Orthop Relat Res. 2012;470:1534–9.CrossRefPubMedPubMedCentral Shimizu T, Iwasaki N, Nishida K, Minami A, Funakoshi T. Glenoid stress distribution in baseball players using computed tomography osteoabsorptiometry: a pilot study. Clin Orthop Relat Res. 2012;470:1534–9.CrossRefPubMedPubMedCentral
9.
go back to reference Hill JA, Tkach L, Hendrix RW. A study of glenohumeral orientation in patients with anterior recurrent shoulder dislocations using computerized axial tomography. Orthop Rev. 1989;18:84–91.PubMed Hill JA, Tkach L, Hendrix RW. A study of glenohumeral orientation in patients with anterior recurrent shoulder dislocations using computerized axial tomography. Orthop Rev. 1989;18:84–91.PubMed
10.
go back to reference Mair SD, Zarzour RH, Speer KP. Posterior labral injury in contact athletes. Am J Sports Med. 1998;26:753–8.CrossRefPubMed Mair SD, Zarzour RH, Speer KP. Posterior labral injury in contact athletes. Am J Sports Med. 1998;26:753–8.CrossRefPubMed
11.
go back to reference Kothary S, Rosenberg ZS, Poncinelli LL, Kwong S. Skeletal development of the glenoid and glenoid-coracoid interface in the pediatric population: MRI features. Skelet Radiol. 2014;43:1281–8.CrossRef Kothary S, Rosenberg ZS, Poncinelli LL, Kwong S. Skeletal development of the glenoid and glenoid-coracoid interface in the pediatric population: MRI features. Skelet Radiol. 2014;43:1281–8.CrossRef
12.
go back to reference Wright RW, Paletta GA Jr. Prevalence of the Bennett lesion of the shoulder in major league pitchers. Am J Sports Med. 2004;32:121–4.CrossRefPubMed Wright RW, Paletta GA Jr. Prevalence of the Bennett lesion of the shoulder in major league pitchers. Am J Sports Med. 2004;32:121–4.CrossRefPubMed
13.
go back to reference Walch G, Badet R, Boulahia A, Khoury A. Morphologic study of the glenoid in primary glenohumeral osteoarthritis. J Arthroplast. 1999;14:756–60.CrossRef Walch G, Badet R, Boulahia A, Khoury A. Morphologic study of the glenoid in primary glenohumeral osteoarthritis. J Arthroplast. 1999;14:756–60.CrossRef
14.
go back to reference Harper KW, Helms CA, Haystead CM, Higgins LD. Glenoid dysplasia: incidence and association with posterior labral tears as evaluated on MRI. AJR Am J Roentgenol. 2005;184:984–8.CrossRefPubMed Harper KW, Helms CA, Haystead CM, Higgins LD. Glenoid dysplasia: incidence and association with posterior labral tears as evaluated on MRI. AJR Am J Roentgenol. 2005;184:984–8.CrossRefPubMed
15.
go back to reference Mirtz TA, Chandler JP, Eyers CM. The effects of physical activity on the epiphyseal growth plates: a review of the literature on normal physiology and clinical implications. J Clin Med Res. 2011;3:1–7.PubMedPubMedCentral Mirtz TA, Chandler JP, Eyers CM. The effects of physical activity on the epiphyseal growth plates: a review of the literature on normal physiology and clinical implications. J Clin Med Res. 2011;3:1–7.PubMedPubMedCentral
16.
go back to reference Ogden JA, Phillips SB. Radiology of postnatal skeletal development. VII. The scapula. Skelet Radiol. 1983;9:157–69.CrossRef Ogden JA, Phillips SB. Radiology of postnatal skeletal development. VII. The scapula. Skelet Radiol. 1983;9:157–69.CrossRef
17.
go back to reference Siffert RS. The effect of trauma to the epiphysis and growth plate. Skelet Radiol. 1977;2:21–30.CrossRef Siffert RS. The effect of trauma to the epiphysis and growth plate. Skelet Radiol. 1977;2:21–30.CrossRef
Metadata
Title
Characterization of glenoid bone remodeling in professional baseball pitchers
Authors
Jonathan Rassi
Naveen Subhas
Jennifer Bullen
Michael Forney
Joshua Polster
Publication date
01-07-2019
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 7/2019
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-018-3121-3

Other articles of this Issue 7/2019

Skeletal Radiology 7/2019 Go to the issue