Sonographic Evaluation of the Extensor Carpi Ulnaris in Asymptomatic Tennis Players
Sonographic Evaluation of the Extensor Carpi Ulnaris in Asymptomatic Tennis Players
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DOI：
10.1016/j.pmrj.2014.08.951
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发表时间：
2015-03-01
期刊：
影响因子：
2.1
通讯作者：
Smith, Jay
中科院分区：
文献类型：
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作者：
Sole, Joshua S.;Wisniewski, Steve J.;Smith, Jay
目的：利用高分辨率超声检查确定影响无症状休闲网球运动员尺侧腕伸肌 (ECU) 肌腱的结构异常和不稳定性的患病率。设计：横断面观察研究。地点：学术运动医学中心。参与者：26 名无症状、休闲男性和女性网球运动员。方法：由一名经验丰富的操作员完成 26 名 ECU 肌腱的双边静态和动态超声检查。年龄 26-61 岁的无症状、长期、休闲网球运动员（11 名男性，15 名女性，平均参与网球年龄 24.4 +/- 14.2 年）。通过标准化扫描方案和预先确定的诊断标准评估肌腱的肌腱变性和撕裂、腱鞘积液和腱鞘炎以及不稳定性。主要结果测量：静态结构性 ECU 肌腱异常（例如肌腱变性、腱鞘炎、撕裂）和动态 ECU 不稳定（例如半脱位、脱位）的患病率。结果：52 只手腕中的 39 只（75%）表现出静态 ECU 肌腱异常，是最常见的。常见的发现是位于尺骨沟远端的部分厚度撕裂。总体而言，92% (24/26) 的玩家至少一只手腕出现肌腱变性或撕裂。 42% (22/52) 的手腕检测到动态 ECU 不稳定，91% (20/22) 的手腕表现为半脱位。仅观察到 2 起 ECU 肌腱脱位，均发生在同一个人身上。总体而言，73% (19/26) 的玩家至少一只手腕表现出 ECU 不稳定。在调查的方法学限制内，静态和动态 ECU 肌腱异常之间没有关系。任何手腕均未出现 ECU 完全撕裂、腱鞘积液、腱鞘炎和静态脱位的情况。结论：在长期、无症状的休闲网球运动员中，可以看到 ECU 肌腱变性、部分厚度撕裂、全层撕裂和半脱位的超声证据，而腱鞘积液、腱鞘炎和腱脱位并不常见。需要进一步的研究来确定多种技能水平的长期网球运动员中无症状 ECU 肌腱异常的临床意义。
Objective: To determine the prevalence of structural abnormalities and instability affecting the extensor carpi ulnaris (ECU) tendons of asymptomatic recreational tennis players by the use of high-resolution ultrasonography.Design: Cross-sectional observational study.Setting: Academic sports medicine center.Participants: Twenty-six asymptomatic, recreational male and female tennis players.Methods: A single, experienced operator completed bilateral static and dynamic ultrasound examinations of the ECU tendons of 26 asymptomatic, long-term, recreational tennis players ages 26-61 years (11 male, 15 female, average 24.4 +/- 14.2 years of tennis participation). Tendons were evaluated for tendinosis and tearing, tendon sheath effusion and tenosynovitis, and instability via a standardized scanning protocol and predetermined diagnostic criteria.Main Outcome Measurements: The prevalence of static structural ECU tendon abnormalities (eg, tendinosis, tenosynovitis, tears) and dynamic ECU instability (eg, subluxation, dislocation).Results: Thirty-nine of 52 wrists (75%) demonstrated static ECU tendon abnormalities, the most common finding being a partial-thickness tear located just distal to the ulnar groove. Overall, 92% (24/26) of players exhibited tendinosis or tearing in at least one wrist. Dynamic ECU instability was detected in 42% of wrists (22/52) and 91% (20/22) of the time manifested as subluxation. Only 2 ECU tendon dislocations were observed, both occurring in the same individual. Overall, 73% (19/26) of players exhibited ECU instability in at least one wrist. There was no relationship between static and dynamic ECU tendon abnormalities within the methodological limits of the investigation. Complete ECU tearing, tendon sheath effusion, tenosynovitis, and static dislocation were not seen in any wrist.Conclusion: Sonographic evidence of ECU tendinosis, partial-thickness tearing, full-thickness tearing, and subluxation can be seen in long-term, asymptomatic, recreational tennis players, whereas tendon sheath effusions, tenosynovitis, and tendon dislocation are uncommon. Further research is warranted to determine the clinical significance of asymptomatic ECU tendon abnormalities among long-term tennis players at multiple skill levels.