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Shoulder and Elbow Injuries in Adult Overhead Throwers: Imaging Review.

Paola Kuenzer Goes¹, Dyan V Flores¹, Alameen Damer¹

¹From the Division of Musculoskeletal Radiology, Laboratorio Delboni Auriemo, DASA Diagnostic Imaging, São Paulo, Brazil (P.K.G.); Department of Radiology, Radiation Oncology and Medical Physics, Faculty of Medicine, University of Ottawa, Ottowa, Ontario, Canada (D.V.F., A.D.); Department of Medical Imaging, The Ottawa Hospital, 501 Smyth Rd, Ottawa, ON, Canada K1H 8L6 (D.V.F.); Ottawa Hospital Research Institute, Ottawa, Ontario, Canada (D.V.F.); and Department of Radiology, Division of Musculoskeletal Imaging and Intervention, University of California San Diego Medical Center, San Diego, Calif (B.K.H.).

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|November 2, 2023

Summary

Overhead throwing causes unique shoulder and elbow injuries, including GIRD, SLAP lesions, and UCL tears. Understanding these throwing-related injuries is key for prevention and treatment.

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Area of Science:

Orthopedic sports medicine
Radiology of throwing injuries
Biomechanics of overhead athletes

Background:

Overhead throwing athletes experience unique shoulder and elbow injuries due to repetitive stress.
These injuries include capsular contracture, glenohumeral internal rotation deficit (GIRD), and superior labrum anterior-posterior (SLAP) lesions.
Elbow injuries often involve medial structures like the ulnar collateral ligament (UCL) and can lead to medial epicondylitis and posteromedial impingement (PMI).

Purpose of the Study:

To review the spectrum of shoulder and elbow injuries in overhead throwing athletes.
To describe the pathophysiology and imaging findings of common throwing-related pathologies.
To highlight the relationship between biomechanical forces and injury development.

Main Methods:

Review of relevant literature on throwing-related injuries.
Discussion of anatomical structures affected and injury mechanisms.
Correlation of clinical presentation with imaging findings.

Main Results:

Repetitive external rotation can cause GIRD, Bennett lesions, posterosuperior internal impingement (PSI), and SLAP lesions.
Scapular dysfunction is linked to PSI and labral/rotator cuff disease.
Elbow injuries include UCL pathology, medial epicondylitis, PMI, and osseous abnormalities like olecranon stress fractures.

Conclusions:

Overhead throwing imposes significant stress, leading to characteristic shoulder and elbow pathologies.
Radiographic and clinical evaluation is crucial for diagnosing and managing these injuries.
Understanding injury mechanisms aids in developing targeted prevention and treatment strategies.