Clinical Value of an Acute Popping Sensation in Throwing Athletes With Medial Elbow Pain for Ulnar Collateral Ligament Injury.

BACKGROUND

Throwing athletes sustaining an ulnar collateral ligament (UCL) injury may recall a popping sensation originating from the medial elbow at the time of injury. There are no studies available that inform clinicians how to utilize this salient anamnestic information and what amount of diagnostic weight to afford to it.

PURPOSE

To assess the diagnostic value of a popping sensation for significant UCL injury in throwing athletes who sustained an injury causing medial elbow pain.

STUDY DESIGN

Cohort study (prognosis); Level of evidence, 3.

METHODS

A total of 207 consecutive patients with throwing-related medial elbow pain were evaluated for UCL injury by the senior author between 2011 and 2016. The presence or absence of a popping sensation was routinely reported by the senior author. Magnetic resonance imaging was evaluated for UCL injury severity and classified into intact, edema/low-grade partial-, high-grade partial-, and full-thickness tears.

RESULTS

The overall frequency of a pop was 26%. The proportion of patients who reported a pop significantly increased with UCL tear severity (

CONCLUSION

A popping sensation at the time of injury in throwing athletes with medial elbow pain was associated with UCL injury severity. When a throwing athlete reports a pop, this should moderately increase a clinician's suspicion for a significant UCL injury. Conversely, absence of a pop should not substantially decrease suspicion for significant UCL injury. The findings of this study allow for the clinical interpretation of the salient anamnestic finding of a pop at the time of injury, which can be used for diagnostic purposes as well as patient counseling. This study provides reference foundation for future studies of predictive and diagnostic factors for UCL injury in throwing athletes.

Informations de copyright

© The Author(s) 2020.

Déclaration de conflit d'intérêts

One or more of the authors has declared the following potential conflict of interest or source of funding: L.S.O. has received grant support from DJO and hospitality payments from Arthrex. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.