scholarly journals Age-Specific Prevalence and Clinical Characteristics of Humeral Medial Epicondyle Apophysitis and Osteochondritis Dissecans: Ultrasonographic Assessment of 4249 Players

2017 ◽  
Vol 5 (5) ◽  
pp. 232596711770770 ◽  
Author(s):  
Kenichi Otoshi ◽  
Shinichi Kikuchi ◽  
Kinshi Kato ◽  
Ryohei Sato ◽  
Takahiro Igari ◽  
...  
Keyword(s):  
Osteochondritis Dissecans ◽  
Morphological Changes ◽  
Medial Epicondyle ◽  
Baseball Players ◽  
Elbow Pain ◽  
Elbow Injuries ◽  
Bony Healing ◽  
History Of ◽  
Study Participants ◽  
Ultrasonographic Assessment

Background: Traction apophysitis of medial epicondyle (MEC) lesions and osteochondritis dissecans (OCD) of the capitellum are common elbow injuries in adolescent baseball players. However, the age-specific prevalence of these pathologies and their influence on elbow pain remain unknown. Purpose: To investigate the age-specific prevalence of each MEC lesion and capitellar OCD and to identify the incidence of elbow pain in each condition. Study Design: Descriptive epidemiology study. Methods: Study participants consisted of 4249 baseball players aged 6 to 17 years. A questionnaire was used to assess history of elbow pain, and morphological changes of the elbow joint were assessed using ultrasonography. Results: Regarding MEC lesions, fragmented (FG) and irregular (IR) lesions both reached their greatest respective prevalence at 11 to 12 years of age. After 14 years of age, IR decreased sharply, whereas FG was maintained at approximately 10%. Hypertrophic (HT) lesions increased sharply, reaching over 50% at 16 years of age, while there was a decrease in IR and FG lesions in the same age group. The prevalence of capitellar OCD remained the same (approximately 2%) throughout all ages except for in players aged 7 to 8 years (>7%). Players with MEC lesions had significantly greater prevalence of a history of elbow pain compared with those without (68.0% vs 39.1%) and were at a significantly greater risk for FG lesions (odds ratio [OR], 4.04; 95% CI, 3.16-5.22) compared with IR (OR, 3.22; 95% CI, 2.44-4.27) and HT lesions (OR, 2.03; 95% CI, 1.75-2.36). Players with capitellar OCD also had a significantly greater risk of a history of elbow pain (OR, 2.34; 95% CI, 1.40-4.11). Conclusion: Controlling the amount of practice and its intensity according to the condition of each player in the preadolescent and adolescent periods may be important in accelerating bony healing and decreasing preventable elbow pain in adulthood.

The Influence of Pitch Velocity on Medial Elbow Pain and Medial Epicondyle Abnormality Among Youth Baseball Players

2020 ◽  
Vol 48 (7) ◽  
pp. 1601-1607 ◽  
Author(s):  
Daisuke Kurokawa ◽  
Takayuki Muraki ◽  
Hiroaki Ishikawa ◽  
Kiyotsugu Shinagawa ◽  
Hideaki Nagamoto ◽  
...  
Keyword(s):  
Medial Epicondyle ◽  
Level Of Evidence ◽  
Baseball Players ◽  
Elbow Pain ◽  
The Past ◽  
Youth Baseball ◽  
Elbow Injuries ◽  
Internal Rotation Angle ◽  
Straight Leg Raise ◽  
The Relationship

Background: Pitch velocity is associated with elbow injuries among skillful baseball players. However, the relationship between pitch velocity and throwing elbow injuries among youth players has not yet been clarified. Purpose: To investigate the influence of pitch velocity on medial elbow pain and medial epicondyle abnormality among youth baseball players. Study Design: Cohort study; Level of evidence, 3. Methods: The participants consisted of 256 elementary school players (mean age, 11 ± 1 years; range, 9-12 years). The medial aspect of the elbow was evaluated using ultrasound imaging. A questionnaire was used to investigate past or present pain in the elbow, background of the players (age, height, body mass index, and years of baseball experience), and playing environment (number of days of practice in a week, experience as a pitcher, and cryotherapy of the shoulder and elbow after practice). Positioning of the scapula, range of motion in shoulder internal/external rotations and hip internal rotation, angle of the straight-leg raise, and heel-to-buttock distance were measured. The pitch velocity was recorded using a pitch velocity radar gun. The relationship between these variables and the presence of medial epicondyle abnormality, as well as past or present elbow pain, were statistically analyzed. Results: A medial epicondyle abnormality was observed in 130 players (51%), elbow pain in the past in 65 players (25%), and elbow pain during the examination in 14 players (5%). Sixty-nine players (27%) experienced elbow pain either in the past or during examination. Abnormality of the medial epicondyle had a relationship with the pitch velocity (odds ratio [OR], 1.1 for increase of 1 km/h; 95% CI, 1.1-1.2; P < .0001) and the number of practice days in a week (OR, 1.8 for increase of the practice days; 95% CI, 1.4-2.5; P < .0001). Pitch velocity was also significantly related with past pain, present pain, and past and/or present pain of the elbow (OR [km/h], 1.1, 1.1, 1.1; 95% CI, 1.0-1.1, 1.0-1.2, 1.1-1.2; P < .0001, P = .002, P < .0001, respectively). Conclusion: Pitch velocity was significantly associated with abnormality of the medial epicondyle and elbow pain. A 10-km/h increase in pitch velocity would increase the risk of medial epicondyle abnormality and medial elbow pain by 3 times.

scholarly journals Asymptomatic Medial Elbow Ultrasound Abnormality in Youth Baseball Players Is an Independent Risk Factor for Elbow Injury: A Prospective Cohort Study

2021 ◽  
Vol 9 (4) ◽  
pp. 232596712098679
Author(s):  
Hitoshi Shitara ◽  
Tsuyoshi Tajika ◽  
Takuro Kuboi ◽  
Tsuyoshi Ichinose ◽  
Tsuyoshi Sasaki ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cohort Study ◽  
External Rotation ◽  
Medial Epicondyle ◽  
Baseball Players ◽  
Elbow Pain ◽  
Elbow Injury ◽  
Youth Baseball ◽  
Elbow Injuries

Background: Youth baseball players who experience elbow pain during the season frequently exhibit radiographic elbow abnormalities. However, it is unknown whether asymptomatic elbow abnormalities are risk factors for in-season elbow injuries. Purpose: To determine whether the preseason presence of asymptomatic medial epicondyle apophysitis is a risk factor for in-season elbow injuries in youth baseball players. Study Design: Cohort study; Level of evidence, 2. Methods: Youth baseball players (N = 210; age range, 7-12 years) with no pain or history of injury in their throwing arms underwent preseason evaluations that included shoulder and elbow range of motion measurements, shoulder muscle strength testing, and ultrasound elbow scans with a multifrequency 13-MHz linear array transducer. Over 1 year of play, the players and their parents maintained daily elbow pain diaries. Elbow injuries were defined as medial elbow symptoms that prevented ball throwing for ≥8 days. Results: The preseason ultrasound evaluation revealed medial epicondyle apophysitis in 59 players. In the year following, elbow injuries occurred in 17 (28.8%) players with preseason medial epicondyle apophysitis and 18 (11.9%) players without apophysitis. Independent predictors of elbow injuries were preseason medial epicondyle apophysitis (odds ratio [OR], 2.488; 95% confidence interval [CI], 1.152-5.376; P = .02) and deficits of abduction (ABD) and external rotation of the dominant shoulder (OR, 0.963; 95% CI, 0.936-0.992; P = .012). Conclusion: Asymptomatic medial epicondyle apophysitis and ABD and external rotation deficits in the dominant shoulder were risk factors for elbow injuries in 7- to 12-year-old youth baseball players. These findings may aid in the design of programs to prevent elbow injuries in this population.

scholarly journals Prevention of Elbow Injuries in Young Baseball Players: A 6-year Longitudinal Study

2018 ◽  
Vol 6 (7_suppl4) ◽  
pp. 2325967118S0012
Author(s):  
Yoshihiro Kotoura ◽  
Toru Morihara ◽  
Yoshikazu Kida ◽  
Tsuyoshi Sukenari ◽  
Ryuhei Furukawa ◽  
...  
Keyword(s):  
Injury Prevention ◽  
Large Scale ◽  
Medial Epicondyle ◽  
Annual Incidence ◽  
Medical Screening ◽  
Baseball Players ◽  
Elbow Pain ◽  
Elbow Injury ◽  
Elbow Injuries ◽  
Prevention Project

Objectives: Injuries in young baseball players are on the rise. However, there are few large-scale related to injury prevention activities. We have continued an injury prevention project in Kyoto, Japan since 2010. The aim of this study was to verify the preventive effect of our project. Methods: We offered medical screening of elbow for elementary and junior high school players. We examined their elbow manually, performed ultrasonography and guided the players how to check their elbow themselves. Additionally, we instructed baseball coaches and parents regarding injury prevention annually. In this study, a cumulative total of 2624 baseball players (mean age 11.0±0.6) who participated in our injury prevention project (2010-2016) were enrolled. We asked them to answer the questionnaire to investigate the experience of elbow pain and evaluated the tenderness of humeral medial epicondyle and range of motion. Ultrasonography of humeral capitellum and medial epicondyle was examined. Subjects with abnormalities on ultrasonography were further examined through radiographic study and osteochondritis dissecans of the humeral capitellum (OCD) was diagnosed. Humeral medial epicondyle apophysitis was diagnosed with abnormalities of ultrasonography, and physical findings. The annual incidence were investigated and analyzed statistically. P < 0.05 was considered significant for all statistical analysis. Results: The mean prevalence rate of OCD was 1.1% and flexion restriction was 12.3%. There were no significant differences in annual incidence. However, the experience rate of elbow pain was 14.4% in 2010 and 4.4% in 2016, tenderness of humeral epicondyle was 32.2% and 5.8%, extension restriction was 12.5% and 6.9%, and humeral medial epicondyle apophysitis was 22.1% and 5.3%, respectively, that significantly reduced year by year (Table 1). Conclusion: There has been increasing recognition for the importance of preventing the overuse injuries among young baseball players. However, large-scale and longitudinal evaluation studies for preventing elbow injuries have not been reported. The prevalence rates of elbow injuries have generally reduced year by year, which indicates that annual medical screening and educational project for young baseball players, coaches and parents would be an effective approach for preventing elbow injury. [Table: see text]

scholarly journals Elbow Injuries in Youth Baseball Players Without Prior Elbow Pain

2013 ◽  
Vol 1 (5) ◽  
pp. 232596711350994 ◽  
Author(s):  
Tetsuya Matsuura ◽  
Naoto Suzue ◽  
Shinji Kashiwaguchi ◽  
Kokichi Arisawa ◽  
Natsuo Yasui
Keyword(s):  
Baseball Players ◽  
Elbow Pain ◽  
Youth Baseball ◽  
Elbow Injuries

scholarly journals Experience Rate of Elbow Pain and Morphological Abnormality of Humeral Medial Epicondyle among Youth Baseball Players

2016 ◽  
Vol 4 (7_suppl4) ◽  
pp. 2325967116S0012
Author(s):  
Yoshihiro Kotoura ◽  
Toru Morihara ◽  
Yoshikazu Kida ◽  
Tsuyoshi Sukenari ◽  
Ryuhei Furukawa ◽  
...  
Keyword(s):  
Medial Epicondyle ◽  
Morphological Abnormality ◽  
Baseball Players ◽  
Elbow Pain ◽  
Youth Baseball

Humeral Retroversion and Injury Risk After Proximal Humeral Epiphysiolysis (Little Leaguer’s Shoulder)

2019 ◽  
Vol 47 (13) ◽  
pp. 3100-3106 ◽  
Author(s):  
Atsushi Ito ◽  
Teruhisa Mihata ◽  
Yuji Hosokawa ◽  
Akihiko Hasegawa ◽  
Masashi Neo ◽  
...  
Keyword(s):  
High School ◽  
Junior High School ◽  
Junior High ◽  
Control Group ◽  
Baseball Players ◽  
Elbow Pain ◽  
Elbow Injury ◽  
Elbow Injuries ◽  
Little Leaguer’S Shoulder ◽  
Humeral Retroversion

Background: The increased humeral retroversion on the dominant side of throwing athletes is thought to result from repetitive throwing motion. Little Leaguer’s shoulder—a rotational stress fracture of the proximal humeral epiphyseal plate—may influence the risk of humeral retroversion and injury of the shoulder or elbow joint. Purpose: To investigate the effect of Little Leaguer’s shoulder on humeral retroversion and the rates of shoulder and elbow injuries. Study Design: Cohort study; Level of evidence, 3. Methods: 10 high school baseball players (average age, 16.6 years; range, 16-18 years) who had experienced Little Leaguer’s shoulder during elementary or junior high school (average age, 12.6 years; range, 11-15 years) were enrolled in the study. As a control group, 22 high school baseball players (average age, 16.9 years; range, 16-18 years) who had never had any shoulder or elbow injury during elementary and junior high school were included. Humeral retroversion on ultrasonographic measurement, shoulder range of motion, and rates of shoulder and elbow injuries were evaluated. Results: Humeral retroversion was significantly greater on the dominant side than on the nondominant side in both players with Little Leaguer’s shoulder (dominant, 104°± 8°; nondominant, 84°± 12°; P < .001) and controls (dominant, 91°± 13°; nondominant, 81°± 10°; P < .001). In the dominant shoulder, humeral retroversion was greater in the Little Leaguer’s shoulder group than in the control group ( P = .008). When the effects of humeral retroversion were excluded, maximal external rotation was significantly less in the dominant shoulder than in the nondominant shoulder in the Little Leaguer’s shoulder group (by 11°± 12°, P = .02), whereas no significant difference was found between dominant (110°± 11°) and nondominant (111°± 13°) shoulders in the control group ( P = .64). The rates of shoulder and elbow pain were significantly higher in the Little Leaguer’s shoulder group (shoulder pain 80%, elbow pain 70%) than in the control group (shoulder pain 9%, P < .001; elbow pain 32%, P = .04). Conclusion: Humeral retroversion was increased in baseball players without any history of shoulder or elbow injury during elementary and junior high school and was further increased in players who had had Little Leaguer’s shoulder. Increased humeral retroversion after Little Leaguer’s shoulder may be a risk factor for future shoulder or elbow injury.

scholarly journals Association Between Osteochondritis Dissecans of the Humeral Capitellum and Medial Epicondyle Lesion in Baseball Players

2021 ◽  
Vol 9 (4) ◽  
pp. 232596712110077
Author(s):  
Keita Kamei ◽  
Norihiro Sasaki ◽  
Eiji Sasaki ◽  
Shizuka Sasaki ◽  
Yuka Kimura ◽  
...  
Keyword(s):  
Osteochondritis Dissecans ◽  
Prevalence Ratio ◽  
Cross Sectional Study ◽  
Medial Epicondyle ◽  
Lesion Group ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Baseball Players ◽  
Overhead Athletes ◽  
Lateral Group

Background: Osteochondritis dissecans (OCD) of the humeral capitellum occurs in adolescent overhead athletes, and medial epicondyle (ME) lesions are also common in this population. Purpose: To evaluate the association between elbow OCD and ME lesions in adolescent baseball players. Study Design: Cross-sectional study; Level of evidence, 3. Methods: This study retrospectively evaluated adolescent baseball players with unstable elbow OCD who underwent surgery between January 2000 and February 2020. Patients were excluded if they had osteoarthritis of the elbow. A total of 139 elbows were included in this study (138 male and 1 female athlete; mean ± SD age, 13.6 ± 1.5 years). The patients were first divided into 2 groups based on OCD location: a central lesion group (72 elbows) and a lateral group (67 elbows). Next, patients were divided according to OCD size into a localized group (56 elbows) and a widespread group (83 elbows). Finally, OCD lesions that were both lateral and widespread were defined as lateral-widespread (60 elbows), resulting in 5 groups. ME apophyseal fragmentation and elongation were evaluated and defined as ME lesions. We then compared the relationship between OCD and ME lesions. Results: Of the 139 elbows, 63 (45.3%) had ME lesions. The prevalence of ME lesion was higher in the lateral group than the central group (56.7% vs 34.7%; P = .009) and higher in the widespread group than the localized group (55.4% vs 30.4%; P = .004). Furthermore, the prevalence ratio of ME lesion was significantly higher in the lateral-widespread group than for other lesions (58.3% vs 35.4%; P = .007). Conclusion: In patients undergoing surgery for capitellar OCD, the presence of ME lesions was more commonly associated with lateral and widespread capitellar lesions when compared with central and localized lesions.

Determinants of substance use among young people attending an urban primary health center in Delhi

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
KA Mogan ◽  
U Venkatesh ◽  
Richa Kapoor ◽  
Mukesh Kumar
Keyword(s):  
Substance Use ◽  
Family History ◽  
Young People ◽  
Economic Status ◽  
Primary Health Center ◽  
Socio Economic Status ◽  
Primary Health ◽  
History Of ◽  
Study Participants ◽  
Substance Involvement

AbstractIntroductionSubstance abuse remains one of the major challenges in young people, as it is one of the top five causes of disability-adjusted life years (DALY). The present study aims to find the prevalence and determinants of substance use among young people attending an urban primary health center in Delhi.MethodologySystematic random sampling was used to enroll the calculated sample size of 190. Substance use was assessed using ASSIST (an Alcohol Smoking Substance Involvement Screening Tool) and brief intervention was given based on the standard guidelines of ASSIST. The total score among the substance users is calculated and divided into Grades 1, 2 or 3. Log binomial regression was performed to quantify the association between substance use and covariates such as age, sex, education, occupation, family history of substance use, socio-economic status and family type. The association was expressed in odds ratio (OR) with 95 percent confidence interval (CI).ResultThe mean age of study participants was 18.6 ± 4.1, ranges from 10 to 24 years. Out of 48 substance users, 43.7% were consuming only tobacco, 22.9% were consuming only alcohol and 33.3% were polysubstance users. The history of substance use among family members of participants was found to be 46.3%. Median substance involvement score of tobacco, alcohol and cannabis users was 19 (IQR: 14.5–22), 19 (IQR: 13.5–25) and 22.5 (IQR: 22–23), respectively. Among tobacco users, 2.7% were Grade 1 and 7.2% were Grade 2. Four (16%), 20 (80%) and one (4%) of alcohol users were Grades 1, 2 and 3, respectively. Among the cannabis users, four (100%) were in the Grade 2 category. The median age of initiation of substance use among users was 16 (range 13–21) years. The analysis shows substance use was almost 25 times (adjusted OR = 25.84, 95% CI 5.65–118.09) more common among males and it increase by 2.5 times with a decrease in socio-economic status (adjusted OR = 2.52, 95% CI 1.27–5.02) and the result is significant. The substance use was almost 7 times higher when there is a family history of substance usage (adjusted OR = 7.40, 95% CI 2.15–25.4). Residential and marital status were not significantly associated with substance use.ConclusionMale sex, lower socio-economic status, participants currently not going to school/college, family history of substance use were found to be significant predictors of substance use among the study participants.

373 Historical Use of Substances for Insomnia Impacts Current Beliefs about Hypnotic Medications

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A148-A149
Author(s):  
Jessica Dietch ◽  
Norah Simpson ◽  
Joshua Tutek ◽  
Isabelle Tully ◽  
Elizabeth Rangel ◽  
...  
Keyword(s):  
Prescription Medication ◽  
Stepped Care ◽  
Future Research ◽  
Prescription Medications ◽  
Over The Counter ◽  
Multiple Treatment ◽  
History Of ◽  
Study Participants ◽  
Beliefs About Medications ◽  
The Impact

Abstract Introduction The purpose of the current study was to examine the relationship between current beliefs about hypnotic medications and historical use of prescription hypnotic medications or non-prescription substances for sleep (i.e., over the counter [OTC] medications, alcohol, and cannabis). Methods Participants were 142 middle age and older adults with insomnia (M age = 62.9 [SD = 8.1]; 71.1% female) enrolled in the RCT of the Effectiveness of Stepped-Care Sleep Therapy In General Practice (RESTING) study. Participants reported on history of substances they have tried for insomnia and completed the Beliefs about Medications Questionnaire-Specific with two subscales assessing beliefs about 1) the necessity for hypnotics, and 2) concerns about potential adverse consequences of hypnotics. Participants were grouped based on whether they had used no substances for sleep (No Subs, 11.6%), only prescription medications (Rx Only, 9.5%), only non-prescription substances (NonRx Only, 26.6%), or both prescription and non-prescription substances (Both, 52.3%). Results Sixty-one percent of the sample had used prescription medication for sleep and 79% had used non-prescription substances (74% OTC medication, 23% alcohol, 34% cannabis). The greater number of historical substances endorsed, the stronger the beliefs about necessity of hypnotics, F(1,140)=23.3, p&lt;.001, but not about concerns. Substance groups differed significantly on necessity beliefs, F(3,1)=10.68, p&lt;.001; post-hocs revealed the Both group had stronger beliefs than the No and NonRx Only groups. Substance groups also differed significantly on the concerns subscale, F(3,1)=6.68, p&lt;.001; post-hocs revealed the NonRx Only group had stronger harm beliefs than the other three groups. Conclusion The majority of the sample had used both prescription and non-prescription substances to treat insomnia. Historical use of substances for treating insomnia was associated with current beliefs about hypnotics. Individuals who had used both prescription and non-prescription substances for sleep in the past had stronger beliefs about needing hypnotics to sleep at present, which may reflect a pattern of multiple treatment failures. Individuals who had only tried non-prescription substances for sleep may have specifically sought alternative substances due to concerns about using hypnotics. Future research should seek to understand the impact of treatment history on engagement in and benefit from non-medication-based treatment for insomnia. Support (if any) 1R01AG057500; 2T32MH019938-26A1

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