How dual modality imaging helps baseball players with elbow pain

Happy Opening Day, America!

The 2017 baseball season has officially started and has already seen some exciting games, including two walk-offs! Thankfully, we have not seen any injuries yet, but when those elbows start to become issues for players, dual-modality imaging will be there ready to help.

Utilizing both an ultrasound (US) as well as magnetic resonance arthrography (MRA), getting the correct diagnosis might be the difference between a season-ending Tommy John surgery and a lengthy year-long recovery or a short rehab assignment in the minor leagues and training facilities. As a baseball fan who has had a few of his favorite players miss time with elbow injuries, I will always take the latter of those two options. As would anyone.

Dual-modality imaging has made an impact already on baseball, ranging from recreational to professional. Johnnes Roedl, MD, PhD of Sidney Medical College in Philadelphia looked at 10-year data on 144 baseball players and there were 191 findings of medial elbow pain including 53 UCL tears.

For diagnosing UCL tears with MRA alone:

Sensitivity: 81%

Specificity: 91%

Accuracy: 88%

Diagnosing UCL tears with MRA coupled with US:

Sensitivity: 96%

Specificity: 99%

Accuracy: 98%

For the 31 patient with ulnar neuritis diagnosing with MRA alone:

Sensitivity: 74%

Specificity: 92%

Accuracy: 88%

MRA coupled with US:

Sensitivity: 90%

Specificity: 100% (!)

Accuracy: 98%

Like baseball, the stats speak for themselves. Except for ‘wins’ for a relief pitcher, do not trust those. There is your fantasy baseball tip for the year. Anyways, where was I? Oh yeah. Radiology.

The MRA and US combination has proved that it has a big advantage when diagnosing elbow injuries, and this combination of modalities could lead to more accurate diagnoses for more than just elbows and help create better rehab plans for players to get them healthier faster.

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