Premature cystic lesions in shoulders of elite junior javelin and volleyball athletes: a comparative evaluation using 3.0 Tesla MRI

• Published in: Journal of shoulder and elbow surgery Vol. 22; no. 6; pp. 792 - 799
• Main Authors: Beitzel, Knut, MA, MD, Beitzel, Kirsten I., MD, Zandt, Julia F., MSc, Buchmann, Stefan, MD, Schwirtz, Ansgar, PhD, Imhoff, Andreas B., MD, Reiser, Maximilian, MD, Brucker, Peter U., MS, MD
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.06.2013
• Subjects: Adolescent; Age of Onset; Asymptomatic Diseases; athletes shoulder; Bone Cysts - epidemiology; glenohumeral internal rotation deficit (GIRD); Humans; Humeral Head - pathology; intraosseous cysts; Javelin; junior; Magnetic Resonance Imaging; magnetic resonance imaging (MRI); Male; Orthopedics; overhead athletes; Range of Motion, Articular; Shoulder - pathology; Shoulder Joint - pathology; Track and Field - injuries; volleyball; Volleyball - injuries; magnetic resonance imaging (MRI); athletes shoulder; intraosseous cysts; Imaging; Basic Science; Javelin; volleyball; overhead athletes; Anatomy Study; glenohumeral internal rotation deficit (GIRD); junior
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2012.07.012

Background The purpose of this study was to evaluate clinical and magnetic resonance imaging (MRI) findings in the shoulders of high performance competitive junior javelin athletes and volleyball players. The hypothesis was that structural lesions already exist in young and asymptomatic overhead athletes. Methods Thirty-one healthy high performance junior elite athletes were included. Group 1 consisted of 15 male javelin throwers (mean age, 17.7 ± 0.8 years) and group 2 of 16 male volleyball players (16.9 ± 1.0 years). Questionnaire-based interviews, comprehensive clinical examination, and shoulder scoring systems (visual analog scale [VAS] and Constant-Murley Score) were completed. Bilateral shoulder imaging was performed using a 3.0 Tesla MRI. Results The Constant-Murley Score of group 1 was 95.5 ± 3.6 and 94.7 ± 4.6 points for group 2. Group 1 demonstrated a mean VAS of 0.9 ± 1.6 and group 2 a mean of 0.6 ± 0.8 points. Postero-superior intraosseous cysts of the humeral head were detected in 73.3% of all javelin throwers in the dominant shoulder, but only in 13.3% in the nondominant shoulder ( P  = .008). In the volleyball group, such cyst formation was rarely seen in 12.5% in the dominant versus 6.3% in the nondominant shoulder ( P  = .66). Conclusion A high percentage of junior elite athletes already demonstrate osseus signs of overloading especially in the group of javelin athletes, although none had a history of prior shoulder pathology. Therefore, junior overhead athletes might be at risk for the early development of structural lesions at the insertion of the posterior rotator cuff similar to lesions already known for adult athletes, even though they do not present clinical signs of overuse at that age.