Imaging of Sports Injuries of the Elbow
The elbow, compared to the lower extremity and shoulder, is much less involved in sports injuries in general; however in specific sports it is nevertheless quite common (e.g., gymnastics). Acute injuries are relatively rare and most injuries are the resul
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Abstract
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Introduction
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Anatomy
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3 B iomechanics 3.1 I ntroduction 3.2 Baseball (and Other Overhead Throwing Sports) 3.3 Golf 3.4 Tennis 3.5 Handball and Soccer (European Football) 3.6 Gymnastics
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I maging the Elbow Introduction Baseball and Overhead Throwing Sports Golf Tennis Handball and Soccer Gymnastics
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Conclusions
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References
M. C. de Jonge (*) Department of Radiology, St Antonius Hospital Midden Nederland, Nieuwegein, The Netherlands e-mail: [email protected] N. P. Vermeulen · M. Maas Department of Radiology, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands
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The elbow, compared to the lower extremity and shoulder, is much less involved in sports injuries in general; however in specific sports it is nevertheless quite common (e.g., gymnastics). Acute injuries are relatively rare and most injuries are the result of overuse. From a biomechanical standpoint two major mechanisms are responsible for this. The first is the athlete who is involved in sports that require a large number of the same repetitive movements like in baseball, specifically in pitchers. The second mechanism is seen in athletes who basically use their arm as a weight-bearing limb like in gymnastics or weightlifting. All known imaging modalities are useful in elbow imaging each with their own merit. Plain films is almost always the first imaging modality used. The clinical situation and the findings on plain films direct the next step of imaging (if necessary). For the evaluation of the soft tissues ultrasound will usually suffice but if more information is needed, especially for the evaluation of the joint, MRI and CT both play important roles. It has to be emphasized that both have their own merits and that they often are complementary to each other.
Med Radiol Diagn Imaging (2020) https://doi.org/10.1007/174_2020_251, © Springer Nature Switzerland AG
M. C. de Jonge et al.
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Introduction
Elbow injuries in athletes are relatively uncommon. Compared to overuse injuries, acute injuries are less common. Acute injuries are most likely the result of direct trauma or a fall on the outstretched arm and can lead to a variety of injuries which are summarized in Table 1 (Fig. 1). Overuse injuries are chronic and are the result of repetitive motions which generate chronic stress on anatomical structures in and around the elbow joint, especially ligaments, tendons, and cartilage. Sports activities that are prone to overuse elbow injuries involve those with extensive use of the arm in throwing (e.g., baseball pitching, javelin), those in which the arm is used as a lever with swinging and/or hitting (e.g., golf, tennis, racquetball), and those in which the arm is turned into a weight-bearing joint (e.g., gymnastics, weightlifting). In addition, sports activities in which the arm is used to block goal fired shots are prone to
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