title: Normative MRI, ultrasound and muscle functional MRI findings in the forearms of asymptomatic elite rowers.
abstract: OBJECTIVE
  Forearm injuries are common and debilitating to elite rowers. Chronic exertional compartment syndrome, intersection syndrome and proximal radial bone stress injuries have been documented in this population. This paper explores the imaging findings related to these conditions in asymptomatic elite rowers.
  
  
  METHODS
  Observational study.
  
  
  METHODS
  19 asymptomatic senior elite and under-23 rowers currently competing at National level or above underwent ultrasound (US), Magnetic Resonance Imaging (MRI) and muscle functional MRI evaluation of their forearms. A comprehensive evaluation sheet identifying characteristics of bone stress, intersection syndrome and chronic exertional compartment syndrome was utilised based on a literature search and review by senior clinicians working with this population.
  
  
  RESULTS
  Peritendinous fluid of Extensor Carpi Radialis Longus (n=10, 53%) or Extensor Carpi Radialis Brevis (n=6, 32%) was a common finding on US. MRI had a higher rate of identification than US. Extensor Digitorum (Coeff=-1.76, 95%CI -3.04 to -0.49), Flexor Carpi Radialis (Coeff=-2.86, 95%CI -5.35 to -0.38) and Flexor Carpi Ulnaris (Coeff=-3.31, 95%CI -5.30 to -1.32), Pronator Teres (Coeff=-3.94, 95%CI -6.89 to -0.99), and Supinator (Coeff=-168, 95%CI -3.28 to -0.02) showed statistically significant changes immediately post-exercise. Mild proximal radial marrow hyperintensity was present (n=15, 78.9%) with three participants (15.8%) also having mild periosteal oedema of the radius.
  
  
  CONCLUSIONS
  Imaging findings commonly seen in symptomatic populations are observed in elite, asymptomatic rowers. Care should be taken when diagnosing bone stress injuries, intersection syndrome and compartment syndrome on imaging findings alone. Data presented can be utilised as a normative dataset for future case studies.
authors.affiliation: Department of Physical Therapies, Australian Institute of Sport, Australia; Department of Physiotherapy, Faculty of Health, University of Canberra, Australia; Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University, Australia. Electronic address: Michael.drew@ausport.gov.au.
authors.forename: Michael K
authors.initials: MK
authors.lastname: Drew
authors.affiliation: Department of Sports Medicine, Rowing Australia, Australia.
authors.forename: Larissa
authors.initials: L
authors.lastname: Trease
authors.affiliation: Department of Physiotherapy, Curtin University, Australia.
authors.forename: J P
authors.initials: JP
authors.lastname: Caneiro
authors.affiliation: Department of Physical Therapies, Australian Institute of Sport, Australia.
authors.forename: Ivan
authors.initials: I
authors.lastname: Hooper
authors.affiliation: Department of Diagnostic Radiology, Singapore General Hospital, Singapore; Department of Diagnostic Radiology, Monash University, Australia.
authors.forename: Chin-Chin
authors.initials: CC
authors.lastname: Ooi
authors.affiliation: Imaging at Olympic Park, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Counsel
authors.affiliation: Imaging at Olympic Park, Australia; Department of Medicine, Nursing and Healthcare, Monash University, Australia.
authors.forename: David A
authors.initials: DA
authors.lastname: Connell
authors.affiliation: Department of Physiology, Australian Institute of Sport, Australia.
authors.forename: Anthony A
authors.initials: AA
authors.lastname: Rice
authors.affiliation: Department of Performance Research, Australian Institute of Sport, Australia.
authors.forename: Emma
authors.initials: E
authors.lastname: Knight
authors.affiliation: Melbourne Orthopaedic Group, Australia.
authors.forename: Gregory
authors.initials: G
authors.lastname: Hoy
authors.affiliation: Department of Sports Medicine, Australian Institute of Sport, Australia.
authors.forename: Gregory
authors.initials: G
authors.lastname: Lovell
mesh_terms: D000328:Adult; D058070:Asymptomatic Diseases; D001265:Athletic Injuries / Q000175:diagnosis* / Q000503:physiopathology; D003161:Compartment Syndromes / Q000175:diagnosis* / Q000503:physiopathology; D012090:Cumulative Trauma Disorders / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D005542:Forearm / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D018482:Muscle, Skeletal / Q000502:physiology*; D055815:Young Adult
keywords: Athletes; Forearm; Intersection syndrome; Magnetic resonance imaging; Rowing; Ultrasound imaging