Imaging of primary periphyseal finger stress injuries in climbers

Periphyseal stress injuries (PPSIs) in young rock climbers are gaining recognition due to the surge in popularity of the sport. These injuries, occurring near the growth plates of fingers, pose diagnostic challenges due to their subtle presentation and potential long-term complications if left untreated. This review emphasizes the importance of radiologists' awareness of PPSIs, covering their anatomy, biomechanics, and imaging findings. Techniques like the "crimp-grip" in climbing exacerbate the vulnerability of the physis, leading to repetitive stress injuries. Imaging modalities such as radiography, MRI, CT, and ultrasound play crucial roles in diagnosis, each with its advantages and limitations. While radiographs remain a cost-effective initial choice, MRI offers detailed soft tissue evaluation and can detect occult injuries. Understanding the pathophysiology and imaging characteristics of PPSIs is essential for early detection and appropriate management to prevent long-term skeletal deformities and growth disturbances in young climbers.