title: High prevalence of self-reported symptoms of digital ischemia in elite male volleyball players in the Netherlands: a cross-sectional national survey.
abstract: BACKGROUND
  In the past 3 years, 6 volleyball players with ischemic digits and small microemboli in the digital arteries of the dominant hand presented themselves in our hospital. These complaints were caused by an aneurysmatic dilation of the posterior circumflex humeral artery (PCHA) with distal occlusion and digital emboli in the isolateral limb. All were elite male volleyball players active in the national top league. Little is known about the exact symptoms associated with PCHA pathological lesions with digital emboli (PCHAP with DE) and its prevalence in elite volleyball players. If vascular injury can be identified at an early stage, thromboembolic complications and irreversible damage to the digits might be prevented.
  
  
  OBJECTIVE
  To assess the prevalence of symptoms that are consistent with digital ischemia and may be caused by PCHAP with DE in elite male volleyball players in the Netherlands.
  
  
  METHODS
  Cross-sectional study; Level of evidence, 3.
  
  
  METHODS
  A questionnaire survey was performed among elite volleyball players in the Dutch national top league and the Dutch beach volleyball team. The questionnaire was constructed using literature-based data on symptoms associated with PCHAP with DE, together with data retrieved from medical files.
  
  
  RESULTS
  A total of 99 of the 107 athletes participated, with a response rate of 93%. The most frequently reported symptoms associated with PCHAP with DE were cold, blue, or pale digits in the dominant hand during or immediately after practice or competition. The prevalence of these symptoms ranged from 11% to 27%. The prevalence of cold digits during practice and competition was 27%. The prevalence of cold, blue, and pale digits during or immediately after practice and competition was 12%.
  
  
  CONCLUSIONS
  An unexpectedly high percentage of elite volleyball players reported symptoms that are associated with PCHAP with DE in the dominant hand. Because these athletes are considered potentially at risk for developing critical digital ischemia, further analysis of the presence of digital ischemia and PCHA injury is warranted.
authors.affiliation: Department of Radiology, Academic Medical Center/University of Amsterdam, PO Box 22700, NL-1100 DE Amsterdam, the Netherlands.
authors.forename: Daan
authors.initials: D
authors.lastname: van de Pol
authors.forename: P Paul F M
authors.initials: PP
authors.lastname: Kuijer
authors.forename: Ton
authors.initials: T
authors.lastname: Langenhorst
authors.forename: Mario
authors.initials: M
authors.lastname: Maas
mesh_terms: D000328:Adult; D000783:Aneurysm / Q000150:complications / Q000000981:diagnostic imaging*; D001265:Athletic Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005385:Fingers / Q000098:blood supply*; D006306:Health Surveys; D006801:Humans; D007511:Ischemia / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D009426:Netherlands; D015995:Prevalence; D011859:Radiography; D057566:Self Report; D013923:Thromboembolism / Q000000981:diagnostic imaging* / Q000209:etiology; D034941:Upper Extremity / Q000098:blood supply; D054798:Volleyball / Q000293:injuries*; D055815:Young Adult