title: Radiographic changes in the hands and fingers of young, high-level climbers.
abstract: BACKGROUND
  In the past few years, competition climbing has grown in popularity, and younger people are being drawn to the sport.
  
  
  OBJECTIVE
  Although the radiographic changes in long-term climbers are known, there are little data available on young climbers. The question arises as to whether climbing at high levels at a young age leads to radiographic changes and possibly an early onset of osteoarthrosis in the finger joints.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Nineteen members of the German Junior National Team and 18 recreational climbers were examined clinically and through radiographs. For comparison, radiographs of 12 young nonclimbers (control group) were collected. Radiographs were evaluated using a standard protocol. For evaluation of the physiologic adaptation, the cortical thickness of the middle phalanx and the Barnett Nordin index were analyzed. The results were compared between the 3 groups and against radiographs of 140 long-term, experienced climbers.
  
  
  RESULTS
  Six climbers (32%) of the German Junior National Team presented a decreased range of motion for the small finger joints; none of the recreational climbers showed this decrease. In 47% of the German Junior National Team and 28% of the recreational climbers, stress reactions could be found: cortical hypertrophy (26% German Junior National Team, 11% recreational climbers), subchondral sclerosis (47% German Junior National Team, 6% recreational climbers), broadened base of the proximal interphalangeal joint (42% German Junior National Team, 28% recreational climbers), and broadened base of the distal interphalangeal joint (16% German Junior National Team, 0 recreational climbers). Signs of an early stage of osteoarthrosis were seen in 1 climber in each group. The control group showed no radiologic abnormalities. The Barnett Nordin index was 0.49 +/- 0.05 in German Junior National Team, 0.49 +/- 0.07 in recreational climbers, and 0.48 +/- 0.08 in the control group. There was no statistically significant difference on the Barnett Nordin index between the groups (German Junior National Team/recreational climbers: P = .89; German Junior National Team/control group: P = .58; recreational climbers/control group: P = .55).
  
  
  CONCLUSIONS
  Intensive training and climbing lead to adaptive reactions; nevertheless, osteoarthrotic changes are rare.
authors.affiliation: Department of Trauma/Orthopedic Surgery, Bamberg Hospital, Bamberg, Germany. volker.schoeffl@t-online.de <volker.schoeffl@t-online.de>
authors.forename: Volker
authors.initials: V
authors.lastname: Schöffl
authors.forename: Thomas
authors.initials: T
authors.lastname: Hochholzer
authors.forename: Andreas
authors.initials: A
authors.lastname: Imhoff
mesh_terms: D000293:Adolescent; D000367:Age Factors; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D005385:Fingers / Q000000981:diagnostic imaging* / Q000473:pathology*; D005858:Germany; D006225:Hand / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D008297:Male; D009051:Mountaineering; D010003:Osteoarthritis / Q000209:etiology*; D011859:Radiography; D016059:Range of Motion, Articular; D011998:Recreation