超音波検査により発見し得たリトルリーグ肩の治療経験

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Background: The usefulness of ultrasonography for diagnosis of elbow disorder at medical check-up has been reported. However, no previous study has clarified the usefulness of ultrasonography for diagnosis of a Little Leaguer's shoulder. The purpose of this study was to evaluate the usefulness of ultrasonography for early diagnosis of a Little Leaguer's shoulder. Methods: 208 primary school baseball players underwent screening of throwing side elbow and shoulder in January, 2011. 41 subjects, who had throwing pain and/or tenderness on the shoulder, received ultrasonographic examination. Ultrasonography revealed that, in 16 subjects, proximal humeral epiphyseal line was wider and deeper on the throwing side than the non-throwing side. These 16 subjects received X-ray examination and conservative treatment at outpatient clinic and in 11 subjects (average age, 10.9 years), epiphyseal separation in the proximal humerus was revealed. We investigated X-ray grading, the period until relief of tenderness, return to play and recurrence. Results: Partial separation of the lateral epiphyseal line was shown in all 11 patients. At an average of 5.0 weeks after screening, the tenderness on the shoulder disappeared. All patients were able to return to play at an average of 7.9 weeks. No recurrence was seen. Conclusion: Widening of the proximal humeral epiphyseal line was shown in 11 of 16 subjects (68.8%), having laterality by ultrasonography. All 11 patients were type I, and early return to play was possible in all patients. The use of the ultrasonography device at medical check-up could be useful for early diagnosis and treatment of a Little Leaguer's shoulder.

超音波検査により発見し得たリトルリーグ肩の治療経験

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