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MRI of Stress Reaction of the Distal Humerus in Elite Tennis Players

Justin C. Lee1,2, Frank A. Malara3, Timothy Wood4, Greg Hoy5, Asif Saifuddin1 and David A. Connell1,3

1 Department of Radiology, Royal National Orthopaedic Hospital NHS Trust, Brockley Hill, Stanmore, Middlesex, HA7 4LP, United Kingdom.
2 Present address: Chelsea and Westminster Hospital, London, United Kingdom.
3 Victoria House Medical Imaging, Melbourne, Australia.
4 Vimy House Private Hospital, Kew, Victoria, Australia.
5 Melbourne Orthopaedic Group, Melbourne, Australia.


Figure 1
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  		Fig. 1 —26-year-old male professional tennis player with mild distal humeral stress reaction. Axial STIR MR image of distal humerus shows mildly increased signal intensity (arrow) occupying less than 25% of cross-sectional area (outlined) of marrow cavity.

 

Figure 2
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  		Fig. 2 —23-year-old male professional tennis player with distal humeral stress reaction. Axial STIR MR image shows patchy increased signal intensity (arrows) within anterior aspect of marrow cavity occupying 38% (outlined) of total cross-sectional area.

 

Figure 3
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  		Fig. 3 —24-year-old male professional tennis player with distal humeral stress reaction. Axial STIR MR image shows entire marrow cavity is of high signal intensity (arrow). Anteromedial periostitis (arrowheads) is evident.

 

Figure 4
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  		Fig. 4A —22-year-old female professional tennis player with distal humeral stress reaction. Sagittal STIR MR image shows marked marrow edema within distal humeral diaphysis (straight arrows). Linear anterior periostitis (curved arrow) is evident.

 

Figure 5
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  		Fig. 4B —22-year-old female professional tennis player with distal humeral stress reaction. Coronal STIR MR image shows extent of marrow edema within distal humeral diaphysis (arrows).

 

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