Epiphyseal stress fractures of finger phalanges in adolescent climbing athletes: a 3.0-Tesla magnetic resonance imaging evaluation.

Abstract

To study the value of 3.0-Tesla magnetic resonance imaging for baseline and follow-up assessment of epiphyseal finger phalanx stress fractures in a collective of 7 consecutive adolescent climbing athletes. Baseline MRI was performed in 8 fingers of 7 adolescent athletes (mean age 13.8 years, female:male = 2:5) with clinically suspected stress fracture of the fingers acquired during climbing sports. Follow-up MRI was performed after functional therapy with training interruption for 6 weeks (n = 6) and 12 weeks (n = 1). Images were analysed retrospectively and independently by two readers using an MRI grading score from 0 (no pathology) to 4 (bone marrow oedema and clear depiction of a sharp fracture line with surrounding inflammatory soft tissue reaction). A total of 8 baseline and 7 follow-up MRIs were analysed. In 7 out of 8 fingers a stress fracture line Salter-Harris III and in all fingers a bone marrow oedema were diagnosed at the epiphyseal base of the middle phalanx. The average grading score was 3.37 in the initial MRI and 1.43 in the follow-up MRI indicating fracture healing in all fingers. Kappa value for interobserver variability was 0.86, representing almost perfect interobserver agreement. 3-T MRI is a promising diagnostic technique for baseline assessment of epiphyseal finger phalanx stress fractures and for follow-up evaluation of fracture healing.