Acute injury of an intervertebral disc in an elite tennis player: a case report.
METHODS
A case report.


OBJECTIVE
To present a previously not described rare case of intradiscal hematoma due to acute trauma in an elite tennis player.


BACKGROUND
Several studies have demonstrated a high frequency of radiological changes in the spine of athletes, especially in sports with high loads on the back. Signs of disc degeneration without disc herniation have frequently been found in magnetic resonance imaging (MRI) studies of the spine of athletes. It has also been shown that radiological abnormalities of the spine in young athletes are correlated to back pain.


METHODS
An elite male tennis player experienced pain in the right buttock after a backhand stroke. He was successfully treated for hip problems and started to play competitive tennis, 2 weeks later. After few games, a backhand stroke again resulted in intense pain projected in the os coccyx region. At examination, there were no neurologic disturbances. At palpation over the spinal processes (Springing test) of L1-L2, the patient experienced intense pain projected to the os coccyx region.


RESULTS
MRI examination showed an injured L1-L2 disc with fluid inside the disc with a signal similar to blood. Four additional MRI examinations were performed 2 weeks and 2 years after the injury until disc degeneration is formed. Radiograph examination before and 2 years after the injury is available.


CONCLUSIONS
In conclusion, trauma in athletes can cause intradiscal hematoma, which probably is a new etiology for disc degeneration. Also that sudden onset of pain in the hip or the gluteal region may be caused by referred pain due to a disc lesion. Intradiscal hematoma can be visualized using MRI.
Baranto
Adad
A
From the Departments of *Orthopaedics and †Radiology, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden.
Hellström
Mikael
M
Swärd
Leif
L
D000208:Acute Disease; D000328:Adult; D001265:Athletic Injuries / Q000150:complications* / Q000000981:diagnostic imaging; D006406:Hematoma / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D007403:Intervertebral Disc / Q000000981:diagnostic imaging / Q000293:injuries*; D055959:Intervertebral Disc Degeneration / Q000000981:diagnostic imaging / Q000209:etiology*; D017116:Low Back Pain / Q000209:etiology; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D011859:Radiography; D013122:Spinal Diseases / Q000000981:diagnostic imaging / Q000209:etiology; D013715:Tennis / Q000293:injuries*