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Prevalence and Clinical Characteristics of Osteochondritis Dissecans of the Humeral Capitellum Among Adolescent Baseball Players

医学 剥脱性骨软骨炎 肘部 射线照相术 投掷 阶段(地层学) 磁共振成像 外科 物理疗法 放射科 机械工程 生物 工程类 古生物学
作者
Yoshikazu Kida,Toru Morihara,Yoshihiro Kotoura,Tatsuya Hojo,Hisakazu Tachiiri,Tsuyoshi Sukenari,Yoshio Iwata,Ryo Furukawa,Ryo Oda,Yuji Arai,Hiroyoshi Fujiwara,Toshikazu Kubo
出处
期刊:American Journal of Sports Medicine [SAGE]
卷期号:42 (8): 1963-1971 被引量:122
标识
DOI:10.1177/0363546514536843
摘要

Background: The prevalence and clinical characteristics of osteochondritis dissecans (OCD) of the humeral capitellum among adolescent baseball players are unknown. Purpose: To determine the OCD prevalence in adolescent competitive baseball players and to investigate the clinical characteristics of these patients. Study Design: Cross-sectional and case-control study; Level of evidence, 3. Methods: A total of 2433 baseball players (mean age, 14.5 ± 1.5 years) belonging to junior high school and high school baseball clubs were enrolled. Players completed a questionnaire, and the elbow of each player’s throwing arm was assessed by ultrasonography. Participants with abnormal results on ultrasonography were further examined through radiographic study. The OCD lesions were classified into stages based on radiographic results, and demographic data were compared between players with and without OCD lesions. Results: Osteochondritis dissecans of the humeral capitellum was found in 82 (3.4%) elbows by ultrasonography. Players with an OCD lesion began playing baseball at an earlier age ( P = .016), had a longer duration of competitive play ( P = .0013), and had experienced more present ( P = .0025) and past ( P < .0001) elbow pain compared with players without a lesion. There were no differences between the 2 groups in the position played ( P = .26). Sixty-eight patients underwent further radiographic examination for OCD (radiography, computed tomography, magnetic resonance imaging). Of these players, 10 (14.7%) were classified as having stage I OCD (radiolucent stage); 26 (38.2%), stage II (fragmentation stage); 9 (13.2%), stage III (loose body stage); 9 (13.2%), stage IV (residual stage); and 14 (23.5%), stage V (postoperative stage). Conclusion: The prevalence of OCD of the humeral capitellum, including latent cases, was 3.4% among adolescent baseball players. Players with OCD lesions began playing baseball at earlier ages, had played for longer periods, and had experienced more elbow pain. The player’s current baseball position may not be related to the existence of OCD lesions in adolescents.
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