title: The gymnasts' hip and groin: a magnetic resonance imaging study in asymptomatic elite athletes.
abstract: OBJECTIVE
  Specific patterns of developmental adaptation of the proximal femur have been recognized in some sports. Gymnastics are characterized by repetitive axial loading and hip rotations in combination with extreme hip positions. It is unknown how and if these forces can affect an immature skeleton in the long term. We sought to evaluate this, by means of magnetic resonance imaging of the hip and groin of such elite asymptomatic athletes.
  
  
  METHODS
  We performed a case-control comparative MR imaging study of both hips and groin of 12 (7 male, 5 female) skeletally mature young (mean age 18.6 years) asymptomatic international level gymnasts with a minimum of 10 years' training with age-matched non-athletes. At the time of recruitment, none of the athletes had a recorded musculoskeletal complaint or injury in the anatomical area around the hip.
  
  
  RESULTS
  The study showed that elite gymnasts share four common morphological characteristics on MRI that deviate from normal and are considered to be the result of adaptational changes to the specific sport: high centre-column-diaphysis angle (coxa valga140° on average), ligamentum teres hypertrophy, friction of the iliotibial band with oedema surrounding the greater trochanter, and a high incidence (62.5 %) of radiological appearances of ischiofemoral impingement.
  
  
  CONCLUSIONS
  Our study showed that elite gymnasts share four common morphological characteristics on MRI that deviate from normal. These findings were in asymptomatic subjects; hence, radiologists and sports physicians should be aware of them in order to avoid unnecessary treatment.
authors.affiliation: Sport Injuries Laboratory, Department of Physical Education and Sport Sciences, Aristotle University of Thessaloniki, Thermi, 54124, Thessaloniki, Greece, apapavasiliou@aol.com.
authors.forename: A
authors.initials: A
authors.lastname: Papavasiliou
authors.forename: T
authors.initials: T
authors.lastname: Siatras
authors.forename: A
authors.initials: A
authors.lastname: Bintoudi
authors.forename: D
authors.initials: D
authors.lastname: Milosis
authors.forename: V
authors.initials: V
authors.lastname: Lallas
authors.forename: E
authors.initials: E
authors.lastname: Sykaras
authors.forename: A
authors.initials: A
authors.lastname: Karantanas
mesh_terms: D000222:Adaptation, Physiological / Q000502:physiology; D000293:Adolescent; D000328:Adult; D056352:Athletes / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D005260:Female; D006115:Greece; D006119:Groin / Q000033:anatomy & histology*; D006173:Gymnastics / Q000706:statistics & numerical data*; D006621:Hip Joint / Q000033:anatomy & histology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D015588:Observer Variation; D055815:Young Adult
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