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Published in: Skeletal Radiology 3/2020

01-03-2020 | Magnetic Resonance Imaging | Scientific Article

Do magnetic resonance imaging abnormalities of the non-dominant wrist correlate with ulnar-sided wrist pain in elite tennis players?

Authors: Sidney M. Levy, Machar Reid, Anne-Marie Montgomery, Elissa Botterill, Stephanie A. Kovalchik, Melanie Omizzolo, Frank Malara, Timothy O. Wood, Gregory A. Hoy, Andrew H. Rotstein

Published in: Skeletal Radiology | Issue 3/2020

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Abstract

Objective

Ulnar-sided injuries of the non-dominant wrist are common in elite tennis players that use the double-handed backhand technique. This study aimed to define the relationship between ulnar-sided wrist pain in symptomatic and asymptomatic elite tennis players, and the presence of abnormalities on magnetic resonance imaging (MRI).

Materials and methods

Fourteen symptomatic tennis players, 14 asymptomatic tennis players, and 12 healthy controls who did not play tennis, were analyzed prospectively, after undergoing MRI of their non-dominant wrist. Five anatomical regions were analyzed, thought to relate to ulnar-sided wrist pain. These consisted of the triangular fibrocartilage complex (TFCC), ulnar collateral ligament (UCL), extensor carpi ulnaris tendon (ECU), osseous-articular structures, and ganglia. Images were independently reviewed by two blinded musculoskeletal radiologists.

Results

Non-dominant, ulnar-sided, wrist pain in elite tennis players was not statistically significantly associated with an increased number of MRI abnormalities when compared with asymptomatic tennis players (p > 0.05). However, some evidence of statistical association was seen with an increased prevalence of ECU tendon abnormalities (OR = 8.0, 95% CI = (0.74, 20.00), p = 0.07). A statistically significant increase in MRI abnormalities of osseous structures (OR = 15.1, 95% CI = (1.56, 656.05), p = 0.02) and the dorsal radioulnar ligament (DRUL) (OR = 12.5, 95% CI = (2.15, 111.11), p = 0.03), was observed in symptomatic players compared with controls.

Conclusions

Non-dominant, ulnar-sided, wrist pain in a subgroup of elite tennis players using a double-handed backhand technique is not associated with a statistically significant increased prevalence of MRI abnormalities when compared with asymptomatic tennis players, other than some evidence of statistical association with ECU tendon abnormalities. Therefore, significance of MRI abnormalities should be interpreted in the context of clinical findings.
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Metadata
Title
Do magnetic resonance imaging abnormalities of the non-dominant wrist correlate with ulnar-sided wrist pain in elite tennis players?
Authors
Sidney M. Levy
Machar Reid
Anne-Marie Montgomery
Elissa Botterill
Stephanie A. Kovalchik
Melanie Omizzolo
Frank Malara
Timothy O. Wood
Gregory A. Hoy
Andrew H. Rotstein
Publication date
01-03-2020
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 3/2020
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-019-03285-y

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