Little Leaguer's shoulder (proximal humeral epiphysiolysis): MRI findings in four boys.
BACKGROUND
Shoulder pain is a common problem among adolescent athletes. A possible cause of such pain that can be diagnosed on MRI is a stress injury to the proximal humerus known as Little Leaguer's shoulder (proximal humeral epiphysiolysis).


OBJECTIVE
Our objective was to describe the MRI appearance of Little Leaguer's shoulder.


METHODS
Four patients (all boys; age range 11-15 years; median 13 years) with clinical, plain radiographic, and MR imaging findings of Little Leaguer's shoulder were studied retrospectively.


RESULTS
MRI demonstrated focal physeal widening in all four boys with extension of physeal signal intensity into the metaphysis on T1-weighted and gradient echo coronal and sagittal sequences. T2-weighted sequences were of limited use in demonstrating the physeal widening, which is critical to the diagnosis. Abnormal high T2-signal intensity was seen in the metaphysis adjacent to the focal physeal widening in all the boys.


CONCLUSIONS
Focal extension of normal physeal T1-weighted and gradient echo signal intensity into the adjacent metaphysis is a sign of stress injury in the proximal humeral physis (Little Leaguer's shoulder). Children should suspend the offending sport to allow healing.
Obembe
Olufolajimi O
OO
Department of Radiology, UVA Health Sciences Center, P.O. Box 800170, Charlottesville, VA 22908, USA. oo7p@virginia.edu
Gaskin
Cree M
CM
Taffoni
Matthew J
MJ
Anderson
Mark W
MW
D000293:Adolescent; D001484:Baseball / Q000293:injuries*; D002648:Child; D012090:Cumulative Trauma Disorders / Q000175:diagnosis* / Q000209:etiology*; D004839:Epiphyses, Slipped / Q000175:diagnosis* / Q000209:etiology*; D006801:Humans; D006811:Humerus / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000473:pathology; D020069:Shoulder Pain / Q000175:diagnosis / Q000209:etiology*