Normative MRI, ultrasound and muscle functional MRI findings in the forearms of asymptomatic elite rowers

M Drew, Larissa Trease, Joao Caneiro, Ivan Hooper, Chinchin Ooi, Peter Counsel, David Connell, Anthony Rice, Emma Knight, Greg Hoy, Greg Hoy, Greg Lovell

Research output: Contribution to journalArticle

Abstract

Objectives: Forearm injuries are common and debilitating to elite rowers. Chronic exertional compartment syndrome, intersection syndrome and proximal radial bone stress injuries have been documented in this population. This paper explores the imaging findings related to these conditions in asymptomatic elite rowers. Design: Observational study. Methods: 19 asymptomatic senior elite and under-23 rowers currently competing at National level or above underwent ultrasound (US), Magnetic Resonance Imaging (MRI) and muscle functional MRI evaluation of their forearms. A comprehensive evaluation sheet identifying characteristics of bone stress, intersection syndrome and chronic exertional compartment syndrome was utilised based on a literature search and review by senior clinicians working with this population. Results: Peritendinous fluid of Extensor Carpi Radialis Longus (n = 10, 53%) or Extensor Carpi Radialis Brevis (n = 6, 32%) was a common finding on US. MRI had a higher rate of identification than US. Extensor Digitorum (Coeff = -1.76, 95%CI -3.04 to -0.49), Flexor Carpi Radialis (Coeff = -2.86, 95%CI -5.35 to -0.38) and Flexor Carpi Ulnaris (Coeff = -3.31, 95%CI -5.30 to -1.32), Pronator Teres (Coeff = -3.94, 95%CI -6.89 to -0.99), and Supinator (Coeff = -168, 95%CI -3.28 to -0.02) showed statistically significant changes immediately post-exercise. Mild proximal radial marrow hyperintensity was present (n = 15, 78.9%) with three participants (15.8%) also having mild periosteal oedema of the radius. Conclusions: Imaging findings commonly seen in symptomatic populations are observed in elite, asymptomatic rowers. Care should be taken when diagnosing bone stress injuries, intersection syndrome and compartment syndrome on imaging findings alone. Data presented can be utilised as a normative dataset for future case studies.
Original languageEnglish
Pages (from-to)103-108
Number of pages6
JournalJournal of Science and Medicine in Sport
Volume19
Issue number2
DOIs
Publication statusPublished - Feb 2016

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Compartment Syndromes
Forearm
Magnetic Resonance Imaging
Bone and Bones
Muscles
Forearm Injuries
Population
Asymptomatic Diseases
Wounds and Injuries
Observational Studies
Edema
Bone Marrow

Cite this

Drew, M ; Trease, Larissa ; Caneiro, Joao ; Hooper, Ivan ; Ooi, Chinchin ; Counsel, Peter ; Connell, David ; Rice, Anthony ; Knight, Emma ; Hoy, Greg ; Hoy, Greg ; Lovell, Greg. / Normative MRI, ultrasound and muscle functional MRI findings in the forearms of asymptomatic elite rowers. In: Journal of Science and Medicine in Sport. 2016 ; Vol. 19, No. 2. pp. 103-108.
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title = "Normative MRI, ultrasound and muscle functional MRI findings in the forearms of asymptomatic elite rowers",
abstract = "Objectives: Forearm injuries are common and debilitating to elite rowers. Chronic exertional compartment syndrome, intersection syndrome and proximal radial bone stress injuries have been documented in this population. This paper explores the imaging findings related to these conditions in asymptomatic elite rowers. Design: Observational study. Methods: 19 asymptomatic senior elite and under-23 rowers currently competing at National level or above underwent ultrasound (US), Magnetic Resonance Imaging (MRI) and muscle functional MRI evaluation of their forearms. A comprehensive evaluation sheet identifying characteristics of bone stress, intersection syndrome and chronic exertional compartment syndrome was utilised based on a literature search and review by senior clinicians working with this population. Results: Peritendinous fluid of Extensor Carpi Radialis Longus (n = 10, 53{\%}) or Extensor Carpi Radialis Brevis (n = 6, 32{\%}) was a common finding on US. MRI had a higher rate of identification than US. Extensor Digitorum (Coeff = -1.76, 95{\%}CI -3.04 to -0.49), Flexor Carpi Radialis (Coeff = -2.86, 95{\%}CI -5.35 to -0.38) and Flexor Carpi Ulnaris (Coeff = -3.31, 95{\%}CI -5.30 to -1.32), Pronator Teres (Coeff = -3.94, 95{\%}CI -6.89 to -0.99), and Supinator (Coeff = -168, 95{\%}CI -3.28 to -0.02) showed statistically significant changes immediately post-exercise. Mild proximal radial marrow hyperintensity was present (n = 15, 78.9{\%}) with three participants (15.8{\%}) also having mild periosteal oedema of the radius. Conclusions: Imaging findings commonly seen in symptomatic populations are observed in elite, asymptomatic rowers. Care should be taken when diagnosing bone stress injuries, intersection syndrome and compartment syndrome on imaging findings alone. Data presented can be utilised as a normative dataset for future case studies.",
keywords = "Athletes, Forearm, Intersection syndrome, Magnetic resonance imaging, Rowing, Ultrasound imaging",
author = "M Drew and Larissa Trease and Joao Caneiro and Ivan Hooper and Chinchin Ooi and Peter Counsel and David Connell and Anthony Rice and Emma Knight and Greg Hoy and Greg Hoy and Greg Lovell",
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Drew, M, Trease, L, Caneiro, J, Hooper, I, Ooi, C, Counsel, P, Connell, D, Rice, A, Knight, E, Hoy, G, Hoy, G & Lovell, G 2016, 'Normative MRI, ultrasound and muscle functional MRI findings in the forearms of asymptomatic elite rowers', Journal of Science and Medicine in Sport, vol. 19, no. 2, pp. 103-108. https://doi.org/10.1016/j.jsams.2015.02.002

Normative MRI, ultrasound and muscle functional MRI findings in the forearms of asymptomatic elite rowers. / Drew, M; Trease, Larissa; Caneiro, Joao; Hooper, Ivan; Ooi, Chinchin; Counsel, Peter; Connell, David; Rice, Anthony; Knight, Emma; Hoy, Greg; Hoy, Greg; Lovell, Greg.

In: Journal of Science and Medicine in Sport, Vol. 19, No. 2, 02.2016, p. 103-108.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Normative MRI, ultrasound and muscle functional MRI findings in the forearms of asymptomatic elite rowers

AU - Drew, M

AU - Trease, Larissa

AU - Caneiro, Joao

AU - Hooper, Ivan

AU - Ooi, Chinchin

AU - Counsel, Peter

AU - Connell, David

AU - Rice, Anthony

AU - Knight, Emma

AU - Hoy, Greg

AU - Hoy, Greg

AU - Lovell, Greg

PY - 2016/2

Y1 - 2016/2

N2 - Objectives: Forearm injuries are common and debilitating to elite rowers. Chronic exertional compartment syndrome, intersection syndrome and proximal radial bone stress injuries have been documented in this population. This paper explores the imaging findings related to these conditions in asymptomatic elite rowers. Design: Observational study. Methods: 19 asymptomatic senior elite and under-23 rowers currently competing at National level or above underwent ultrasound (US), Magnetic Resonance Imaging (MRI) and muscle functional MRI evaluation of their forearms. A comprehensive evaluation sheet identifying characteristics of bone stress, intersection syndrome and chronic exertional compartment syndrome was utilised based on a literature search and review by senior clinicians working with this population. Results: Peritendinous fluid of Extensor Carpi Radialis Longus (n = 10, 53%) or Extensor Carpi Radialis Brevis (n = 6, 32%) was a common finding on US. MRI had a higher rate of identification than US. Extensor Digitorum (Coeff = -1.76, 95%CI -3.04 to -0.49), Flexor Carpi Radialis (Coeff = -2.86, 95%CI -5.35 to -0.38) and Flexor Carpi Ulnaris (Coeff = -3.31, 95%CI -5.30 to -1.32), Pronator Teres (Coeff = -3.94, 95%CI -6.89 to -0.99), and Supinator (Coeff = -168, 95%CI -3.28 to -0.02) showed statistically significant changes immediately post-exercise. Mild proximal radial marrow hyperintensity was present (n = 15, 78.9%) with three participants (15.8%) also having mild periosteal oedema of the radius. Conclusions: Imaging findings commonly seen in symptomatic populations are observed in elite, asymptomatic rowers. Care should be taken when diagnosing bone stress injuries, intersection syndrome and compartment syndrome on imaging findings alone. Data presented can be utilised as a normative dataset for future case studies.

AB - Objectives: Forearm injuries are common and debilitating to elite rowers. Chronic exertional compartment syndrome, intersection syndrome and proximal radial bone stress injuries have been documented in this population. This paper explores the imaging findings related to these conditions in asymptomatic elite rowers. Design: Observational study. Methods: 19 asymptomatic senior elite and under-23 rowers currently competing at National level or above underwent ultrasound (US), Magnetic Resonance Imaging (MRI) and muscle functional MRI evaluation of their forearms. A comprehensive evaluation sheet identifying characteristics of bone stress, intersection syndrome and chronic exertional compartment syndrome was utilised based on a literature search and review by senior clinicians working with this population. Results: Peritendinous fluid of Extensor Carpi Radialis Longus (n = 10, 53%) or Extensor Carpi Radialis Brevis (n = 6, 32%) was a common finding on US. MRI had a higher rate of identification than US. Extensor Digitorum (Coeff = -1.76, 95%CI -3.04 to -0.49), Flexor Carpi Radialis (Coeff = -2.86, 95%CI -5.35 to -0.38) and Flexor Carpi Ulnaris (Coeff = -3.31, 95%CI -5.30 to -1.32), Pronator Teres (Coeff = -3.94, 95%CI -6.89 to -0.99), and Supinator (Coeff = -168, 95%CI -3.28 to -0.02) showed statistically significant changes immediately post-exercise. Mild proximal radial marrow hyperintensity was present (n = 15, 78.9%) with three participants (15.8%) also having mild periosteal oedema of the radius. Conclusions: Imaging findings commonly seen in symptomatic populations are observed in elite, asymptomatic rowers. Care should be taken when diagnosing bone stress injuries, intersection syndrome and compartment syndrome on imaging findings alone. Data presented can be utilised as a normative dataset for future case studies.

KW - Athletes

KW - Forearm

KW - Intersection syndrome

KW - Magnetic resonance imaging

KW - Rowing

KW - Ultrasound imaging

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UR - http://www.mendeley.com/research/normative-mri-ultrasound-muscle-functional-mri-findings-forearms-asymptomatic-elite-rowers

U2 - 10.1016/j.jsams.2015.02.002

DO - 10.1016/j.jsams.2015.02.002

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EP - 108

JO - Australian Journal of Science and Medicine in Sport

JF - Australian Journal of Science and Medicine in Sport

SN - 1440-2440

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ER -