News | Magnetic Resonance Imaging (MRI) | June 04, 2021

Improved Elbow MRI View for Major League Baseball Pitchers

According to a pilot study published in ARRS’ American Journal of Roentgenology (AJR), the flexed elbow valgus external rotation (FEVER) view can improve magnetic resonance imaging (MRI) evaluation of the ulnar collateral ligament (UCL) in Major League Baseball (#MLB) pitchers.

(A) Side view of volunteer demonstrating proper positioning for FEVER view; note elevated flexed elbow and sandbags to induce valgus stress. Elbow coil is not included in image.

(B) Coronal fat-saturated proton-density weighted MR image in FEVER view in 20-year-old male pitcher shows normal anterior bundle of UCL (blue arrow) and 2.9 mm UT articular width.

Because standard positioning for elbow MRI is often suboptimal for UCL rendering, Knoblauch, Arizona Diamondbacks head team physician Gary Waslewski, and colleagues piloted their study to assess FEVER view impact on ulnotrochlear (UT) joint space measurement and UCL reader evaluation, as incorporated with conventional elbow MRI.

June 4, 2021 — According to a pilot study published in ARRS’ American Journal of Roentgenology (AJR), the flexed elbow valgus external rotation (FEVER) view can improve magnetic resonance imaging (MRI) evaluation of the ulnar collateral ligament (UCL) in Major League Baseball (MLB) pitchers.

“The increased joint space width confirms elbow valgus stress with FEVER view,” wrote corresponding author Thomas Knoblauch at the University of Nevada Las Vegas. “Diagnostic confidence increased, and additional UCLs were identified as abnormal.”

Due to repetitive extreme valgus stress during overhead throwing maneuvers, UCL injuries remain common in throwing athletes. Because standard positioning for elbow MRI is often suboptimal for UCL rendering, Knoblauch, Arizona Diamondbacks head team physician Gary Waslewski, M.D. and colleagues piloted their study to assess FEVER view impact on ulnotrochlear (UT) joint space measurement and UCL reader evaluation, as incorporated with conventional elbow MRI.

A total of 44 MLB pitchers underwent elbow MRI, including both standard sequences and a coronal fat-saturated proton density-weighted sequence in the FEVER view using specific positioning maneuvers and sandbags to immobilize the elbow in valgus stress, while visualizing the UCL parallel to its long axis. To measure UT joint space and assess confidence in UCL-related findings with overall UCL normality, two radiologists independently evaluated standard and FEVER views.

“Among 44 MLB pitchers undergoing elbow MRI,” Knoblauch et al. continued, “the FEVER view, compared with standard view, yielded increased UT joint space width (mean increase, 1.80 mm) and increased confidence for three of five UCL-related findings (mean increase, -0.14 to 0.98).” Readers 1 and 2 classified 3 and 2 additional UCLs as abnormal on FEVER compared with standard view; neither reader classified any UCL as abnormal in standard view but normal in FEVER view.

“The findings support the FEVER view as a practical addition to standard elbow MRI protocols for achieving elbow valgus stress in throwing athletes,” the authors of this AJR article concluded, “thereby providing functional information to complement the high-resolution anatomic assessment provided by MRI.”

For more information: www.arrs.org

Related Sports Injury Content:

Teenage Baseball Pitchers at Risk for Permanent Shoulder Injury

MRI Plays Role in Developing Novel Device to Help Protect Athletes’ Brains During Head Impacts

Ohio State Study Shows Cardiac MRI Effective in Identifying Myocarditis in Athletes

The Carestream DRX-Revolution Assists Athletes at the 2020 US Open

 

Related Content

64-Year-Old Man With Clear Cell Likelihood Score (ccLS) 5 Renal Masses

64-Year-Old Man With Clear Cell Likelihood Score (ccLS) 5 Renal Masses. Coronal T2-weighted single shot fast spin echo and coronal T1-weighted fat-saturated spoiled gradient echo acquired during corticomedullary phase—ccLS5 lesion outlined red for clarity.

News | Magnetic Resonance Imaging (MRI) | July 22, 2021
SurveyVitals, a leading patient experience analytics provider, announced it has joined forces with the Radiology Business Management Association (RBMA) to launch Postmarks, a real-time patient and partner feedback software solution
News | Patient Engagement | July 22, 2021
July 22, 2021 — SurveyVitals, a leading patient experie
This change will be debuted at HIMSS 2021, and Vital will be exhibiting as Canon Medical for the first time
News | Information Technology | July 22, 2021
July 22, 2021 — Canon Medical Systems Corpora
Registration is now open for the Radiological Society of North America (RSNA) 107th Scientific Assembly and Annual Meeting, the world’s largest annual radiology forum, to be held at McCormick Place Chicago, Nov. 28 – Dec. 2, 2021

Getty Images

News | RSNA | July 21, 2021
July 21, 2021 — Registration is now open for the Radiological Society of North America (...