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Skeletal Radiol (2013) 42:15211525 DOI 10.1007/s00256-013-1694-4
SCIENTIFIC ARTICLE
Epiphyseal stress fractures of finger phalanges in adolescent climbing athletes: a 3.0-Tesla magnetic resonance imaging evaluation
Thomas Bayer & Volker Rainer Schffl &
Markus Lenhart & Thomas Herold
Received: 29 April 2013 /Revised: 28 May 2013 /Accepted: 9 June 2013 /Published online: 7 August 2013 # ISS 2013
AbstractObjectives To study the value of 3.0-Tesla magnetic resonance imaging for baseline and follow-up assessment of epiphyseal finger phalanx stress fractures in a collective of 7 consecutive adolescent climbing athletes.
Materials and methods Baseline MRI was performed in 8 fingers of 7 adolescent athletes (mean age 13.8 years, female: male=2:5) with clinically suspected stress fracture of the fingers acquired during climbing sports. Follow-up MRI was performed after functional therapy with training interruption for 6 weeks (n=6) and 12 weeks (n=1). Images were analysed retrospectively and independently by two readers using an MRI grading score from 0 (no pathology) to 4 (bone marrow oedema and clear depiction of a sharp fracture line with surrounding inflammatory soft tissue reaction).
Results A total of 8 baseline and 7 follow-up MRIs were analysed. In 7 out of 8 fingers a stress fracture line Salter Harris III and in all fingers a bone marrow oedema were diagnosed at the epiphyseal base of the middle phalanx. The average grading score was 3.37 in the initial MRI and 1.43 in the follow-up MRI indicating fracture healing in all fingers. Kappa value for interobserver variability was 0.86, representing almost perfect interobserver agreement.
Conclusions 3-T MRI is a promising diagnostic technique for baseline assessment of epiphyseal finger phalanx stress fractures and for follow-up evaluation of fracture healing.
Keywords Adolescence . Climbing . Epiphyseal stress fracture . Finger phalanx . MRI
Introduction
Epiphyseal stress fractures of finger phalanges are frequently encountered injuries in adolescent competitive climbers [1, 2]. The incidence is growing, with a high popularity of climbing sports and increasing levels of competitive events. A study by Hochholzer and Schoffl reported 24 adolescent climbers with a mean age of 14.5 years with epiphyseal stress fracture of the finger phalanges between 1994 and 2004 [1]. These fractures may have a bad prognosis, especially when the diagnosis is delayed, which may lead to insufficient treatment. An axial deviation of the...