MRI shows new types of injuries in young gymnasts

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CHICAGO—Adolescent gymnasts are developing a wide variety of arm, wrist and hand injuries that are beyond the scope of previously described gymnastic-related trauma, according to a study presented today at the 94th annual meeting of the Radiological Society of North America (RSNA).

“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,” said the study’s lead author, Jerry Dwek, MD, an assistant clinical professor of radiology at the University of California, San Diego, who presented the findings.

He reported that the study uncovered some injuries to the bones in the wrists and knuckles that have not been previously described. In addition, the researchers noted that the gymnasts had necrosis of the bones of their knuckles. Dwek said that it is not unusual for gymnasts to have a longer ulna than radius. Some former gymnasts must undergo surgery to shorten the ulna and regain the proper fit of the wrist bones into the forearm.

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

Dwek and co-author Christine Chung, MD, used MR to study overuse injuries seen in the skeletally immature wrists and hands of gymnasts. The researchers studied wrist and hand images of 125 patients, age 12 to 16, 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. “These types of injuries are likely to develop into early osteoarthritis.”

Dwek suggested that additional studies are needed to understand how gymnastic stresses are causing these injuries. However, he added that “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.”