title: Epiphyseal stress fractures of finger phalanges in adolescent climbing athletes: a 3.0-Tesla magnetic resonance imaging evaluation.
abstract: OBJECTIVE
  To study the value of 3.0-Tesla magnetic resonance imaging for baseline and follow-up assessment of epiphyseal finger phalanx stress fractures in a collective of 7 consecutive adolescent climbing athletes.
  
  
  METHODS
  Baseline MRI was performed in 8 fingers of 7 adolescent athletes (mean age 13.8 years, female:male = 2:5) with clinically suspected stress fracture of the fingers acquired during climbing sports. Follow-up MRI was performed after functional therapy with training interruption for 6 weeks (n = 6) and 12 weeks (n = 1). Images were analysed retrospectively and independently by two readers using an MRI grading score from 0 (no pathology) to 4 (bone marrow oedema and clear depiction of a sharp fracture line with surrounding inflammatory soft tissue reaction).
  
  
  RESULTS
  A total of 8 baseline and 7 follow-up MRIs were analysed. In 7 out of 8 fingers a stress fracture line Salter-Harris III and in all fingers a bone marrow oedema were diagnosed at the epiphyseal base of the middle phalanx. The average grading score was 3.37 in the initial MRI and 1.43 in the follow-up MRI indicating fracture healing in all fingers. Kappa value for interobserver variability was 0.86, representing almost perfect interobserver agreement.
  
  
  CONCLUSIONS
  3-T MRI is a promising diagnostic technique for baseline assessment of epiphyseal finger phalanx stress fractures and for follow-up evaluation of fracture healing.
authors.affiliation: Department of Radiology, Klinikum Bamberg, Buger Straße 80, 96049, Bamberg, Germany, thomas.bayer@uk-erlangen.de.
authors.forename: Thomas
authors.initials: T
authors.lastname: Bayer
authors.forename: Volker Rainer
authors.initials: VR
authors.lastname: Schöffl
authors.forename: Markus
authors.initials: M
authors.lastname: Lenhart
authors.forename: Thomas
authors.initials: T
authors.lastname: Herold
mesh_terms: D000293:Adolescent; D001265:Athletic Injuries / Q000473:pathology*; D005260:Female; D005383:Finger Injuries / Q000473:pathology*; D050278:Finger Phalanges / Q000293:injuries* / Q000473:pathology*; D015775:Fractures, Stress / Q000473:pathology*; D006132:Growth Plate / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D000072042:Salter-Harris Fractures
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