title: Wrist pain, distal radial physeal injury, and ulnar variance in young gymnasts: does a relationship exist?
abstract: BACKGROUND
  Chronic wrist pain affects up to 79% of young gymnasts. Distal radial growth plate injury and positive ulnar variance have also been reported in this population.
  
  
  OBJECTIVE
  There is a relationship between wrist pain, radiographic findings of distal radial growth plate injury, and ulnar variance in skeletally immature young gymnasts.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Fifty-nine gymnasts (28 girls and 31 boys; average age, 9.3 years) completed a questionnaire detailing training and wrist pain symptoms. Each received a wrist examination, grip strength measurement, and bilateral wrist radiographs.
  
  
  RESULTS
  Wrist pain was reported by 56% of the gymnasts (33 of 59), with 45% (15 of 33) describing pain of at least 6 months' duration. Factors significantly associated with wrist pain included higher skill level, older age, and more years of training. For those between 10 and 14 years of age, 83% had wrist pain, compared with 44% for those outside of that age range. Fifty-one percent of the gymnasts (30 of 59) had findings of stress injury to the distal radial physis of at least a grade 2; 7% (4) had frank widening of the growth plate. Wrist pain prevalence was significantly related to the grade of radiographic injury. Mean ulnar variance was significantly more positive than established norms. Ulnar variance was not associated with wrist pain or radiographic injury of the distal radial physis.
  
  
  CONCLUSIONS
  Radiographic findings of distal radial physeal injury are associated with wrist pain among young nonelite gymnasts.
authors.affiliation: Department of Family Medicine, Los Angeles, California 90095, USA.
authors.forename: John P
authors.initials: JP
authors.lastname: DiFiori
authors.forename: James C
authors.initials: JC
authors.lastname: Puffer
authors.forename: Bassil
authors.initials: B
authors.lastname: Aish
authors.forename: Frederick
authors.initials: F
authors.lastname: Dorey
mesh_terms: D000293:Adolescent; D018771:Arthralgia / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D012090:Cumulative Trauma Disorders / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D006132:Growth Plate / Q000000981:diagnostic imaging*; D006173:Gymnastics / Q000293:injuries; D006801:Humans; D008297:Male; D015995:Prevalence; D011859:Radiography; D011884:Radius / Q000000981:diagnostic imaging* / Q000473:pathology; D014457:Ulna / Q000000981:diagnostic imaging* / Q000473:pathology