MRI reveals new injuries in young gymnasts that could lead to osteoarthritis

Adolescent gymnasts are developing a wide variety of arm, wrist and hand injuries that are beyond the scope of previously described gymnastics-related trauma, according to a study presented this week at the Radiological Society of North America 2008 Annual Meeting.

“The broad constellation of recent injuries is unusual and might point to something new going on in gymnastics training that is affecting young athletes in different ways,” lead investigator Jerry Dwek, MD, assistant clinical professor of radiology at the University of California, San Diego, said in a press release.

Previous studies reported on numerous injuries to the growing portion of adolescent gymnasts’ bones, he said in the press release. However, this study uncovered some injuries to the bones in the wrists and knuckles that have not been previously described.

The researchers also noted that these gymnasts showed signs of necrosis of the bones in their knuckles.

“These young athletes are putting an enormous amount of stress on their joints and possibly ruining them for the future,” Dwek said in the press release.

The radius is particularly prone to injury in gymnastics. Due to damage to the radial growth plates, the bone often does not grow in proportion to the rest of the skeleton and may be deformed, he said. Consequently, it is not unusual for gymnasts to have a longer ulna than radius, and some former gymnasts must undergo surgery to shorten the ulna and regain the proper fit of the wrist bones into the forearm.

Dwek and co-investigator Christine Chung, MD, used MRI to study overuse injuries seen in the skeletally immature wrists and hands of gymnasts. The researchers studied wrist and hand images of 125 patients aged 12 to 16 years, including 12 gymnasts with chronic wrist or hand pain.

“We were surprised to be looking at injuries every step down the hand, all the way from the radius to the small bones in the wrist and on to the ends of the finger bones at the knuckles,” Dwek said in the press release. “These types of injuries are likely to develop into early osteoarthritis.”

He said more study is needed to understand how gymnastic stresses are causing these injuries.

“It is possible that by changing the way that practice routines are performed, we might be able to limit the stress on the joints and on delicate growing bones,” Dwek said.

Reference:
Dwek J, Chung C. MR imaging of overuse injuries in the skeletally immature gymnast: Spectrum of soft tissue and osseous lesions in the hand and wrist. SSQ18-08. Presented at the Radiological Society of North America 2008 Annual Meeting. Nov. 30-Dec. 5, 2008. Chicago.